Provider Demographics
NPI:1134353667
Name:GRIFFIN, KELLEY A (LMHC)
Entity type:Individual
Prefix:
First Name:KELLEY
Middle Name:A
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 HAVERHILL RD
Mailing Address - Street 2:SUITE 322
Mailing Address - City:AMESBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01913-2123
Mailing Address - Country:US
Mailing Address - Phone:978-388-6100
Mailing Address - Fax:
Practice Address - Street 1:110 HAVERHILL RD
Practice Address - Street 2:SUITE 322
Practice Address - City:AMESBURY
Practice Address - State:MA
Practice Address - Zip Code:01913
Practice Address - Country:US
Practice Address - Phone:978-388-6100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7233101YM0800X
MA4328191041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health