Provider Demographics
NPI:1821538380
Name:GRIFFEL, SAM (LCPC)
Entity Type:Individual
Prefix:
First Name:SAM
Middle Name:
Last Name:GRIFFEL
Suffix:
Gender:M
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 W SILVER ST
Mailing Address - Street 2:APT UW
Mailing Address - City:BUTTE
Mailing Address - State:MT
Mailing Address - Zip Code:59701-1438
Mailing Address - Country:US
Mailing Address - Phone:406-671-8704
Mailing Address - Fax:
Practice Address - Street 1:1012 W SILVER ST
Practice Address - Street 2:APT UW
Practice Address - City:BUTTE
Practice Address - State:MT
Practice Address - Zip Code:59701-1438
Practice Address - Country:US
Practice Address - Phone:406-671-8704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-03
Last Update Date:2017-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT1290101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health