Provider Demographics
NPI:1750457867
Name:GRIFFIN, WILLENE PETERS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:WILLENE
Middle Name:PETERS
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3864 ALETHA DR
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70814-4501
Mailing Address - Country:US
Mailing Address - Phone:225-205-7692
Mailing Address - Fax:225-246-8811
Practice Address - Street 1:3864 ALETHA DR
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70814-4501
Practice Address - Country:US
Practice Address - Phone:225-205-7692
Practice Address - Fax:225-246-8811
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA41611041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical