Provider Demographics
NPI:1780431072
Name:VANDERGRIFF, CARYN (LAPC)
Entity type:Individual
Prefix:
First Name:CARYN
Middle Name:
Last Name:VANDERGRIFF
Suffix:
Gender:F
Credentials:LAPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 WOODROW WILSON DR STE A
Mailing Address - Street 2:
Mailing Address - City:VALDOSTA
Mailing Address - State:GA
Mailing Address - Zip Code:31602-2583
Mailing Address - Country:US
Mailing Address - Phone:229-539-1844
Mailing Address - Fax:
Practice Address - Street 1:111 WOODROW WILSON DR STE A
Practice Address - Street 2:
Practice Address - City:VALDOSTA
Practice Address - State:GA
Practice Address - Zip Code:31602-2583
Practice Address - Country:US
Practice Address - Phone:229-539-1844
Practice Address - Fax:229-231-3101
Is Sole Proprietor?:No
Enumeration Date:2024-05-03
Last Update Date:2024-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional