Provider Demographics
NPI:1003637513
Name:GRIFFIN, ALLISON (LPC)
Entity type:Individual
Prefix:
First Name:ALLISON
Middle Name:
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 1:9831 CAPE VERDE LN
Mailing Address - Street 2:
Mailing Address - City:BLACKWATER
Mailing Address - State:MO
Mailing Address - Zip Code:65322-2225
Mailing Address - Country:US
Mailing Address - Phone:660-888-9114
Mailing Address - Fax:
Practice Address - Street 1:18911 HWY CC
Practice Address - Street 2:
Practice Address - City:BLACKWATER
Practice Address - State:MO
Practice Address - Zip Code:65322
Practice Address - Country:US
Practice Address - Phone:888-442-6951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2021030436101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional