Provider Demographics
NPI:1700921475
Name:SELF AWARENESS WORKSHOP INC
Entity Type:Organization
Organization Name:SELF AWARENESS WORKSHOP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SUE
Authorized Official - Middle Name:B
Authorized Official - Last Name:GRIFFITHS
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:305-666-7353
Mailing Address - Street 1:420 S DIXIE HWY
Mailing Address - Street 2:
Mailing Address - City:CORAL GABLES
Mailing Address - State:FL
Mailing Address - Zip Code:33146-2222
Mailing Address - Country:US
Mailing Address - Phone:305-666-7353
Mailing Address - Fax:305-666-7353
Practice Address - Street 1:420 S DIXIE HWY
Practice Address - Street 2:SUITE 4A
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33146-2222
Practice Address - Country:US
Practice Address - Phone:305-666-7353
Practice Address - Fax:305-666-7353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY0003434103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty