Provider Demographics
NPI:1184476855
Name:GRIFFEN, ALESIA MICHELLE RUSHING (LCSW)
Entity type:Individual
Prefix:MRS
First Name:ALESIA
Middle Name:MICHELLE RUSHING
Last Name:GRIFFEN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:ALESIA
Other - Middle Name:MICHELLE
Other - Last Name:RUSHING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7354 BRAES COR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78244-2287
Mailing Address - Country:US
Mailing Address - Phone:205-276-8810
Mailing Address - Fax:
Practice Address - Street 1:2817 ROCK MERRITT AVE
Practice Address - Street 2:
Practice Address - City:FORT BRAGG
Practice Address - State:NC
Practice Address - Zip Code:28310-5654
Practice Address - Country:US
Practice Address - Phone:910-907-8922
Practice Address - Fax:910-907-6069
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-04
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1054971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical