Provider Demographics
NPI:1720273766
Name:GRIFFIN, CYNTHIA LUCAS
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:LUCAS
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 BECKFORD ST
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3206
Mailing Address - Country:US
Mailing Address - Phone:978-745-9448
Mailing Address - Fax:978-745-3326
Practice Address - Street 1:14 BECKFORD ST
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3206
Practice Address - Country:US
Practice Address - Phone:978-745-9448
Practice Address - Fax:978-745-3326
Is Sole Proprietor?:No
Enumeration Date:2007-09-12
Last Update Date:2007-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health