Provider Demographics
NPI:1457375602
Name:GRIFFIN, RICHARD BALDWIN JR (PSYD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:BALDWIN
Last Name:GRIFFIN
Suffix:JR
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8928 COOK DR
Mailing Address - Street 2:
Mailing Address - City:HAYES
Mailing Address - State:VA
Mailing Address - Zip Code:23072-3863
Mailing Address - Country:US
Mailing Address - Phone:804-642-1118
Mailing Address - Fax:
Practice Address - Street 1:606 DENBIGH BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23608-4413
Practice Address - Country:US
Practice Address - Phone:757-872-8303
Practice Address - Fax:757-872-6857
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0810001717103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical