Provider Demographics
NPI:1972385904
Name:GRIFFIN, LANCE LABROCH (PLPC)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:LABROCH
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7878 LASALLE AVE APT 27
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-8358
Mailing Address - Country:US
Mailing Address - Phone:706-372-1037
Mailing Address - Fax:
Practice Address - Street 1:11052 OLD HAMMOND HWY
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70816-8315
Practice Address - Country:US
Practice Address - Phone:225-341-2853
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-16
Last Update Date:2024-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9946101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health