Provider Demographics
NPI:1710173331
Name:GRIFFIN, SANDRA P (LPC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:P
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 COMMERCE CIR STE B
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:AL
Mailing Address - Zip Code:35758-1819
Mailing Address - Country:US
Mailing Address - Phone:256-468-5733
Mailing Address - Fax:251-650-4060
Practice Address - Street 1:102 COMMERCE CIR STE B
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:AL
Practice Address - Zip Code:35758-1819
Practice Address - Country:US
Practice Address - Phone:256-468-5733
Practice Address - Fax:251-650-4060
Is Sole Proprietor?:No
Enumeration Date:2007-09-18
Last Update Date:2007-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2558101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor