Provider Demographics
NPI:1780734814
Name:GRIFFITH, WILLIAM (PHD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:GRIFFITH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 LAFAYETTE RD
Mailing Address - Street 2:BLDG E
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5455
Mailing Address - Country:US
Mailing Address - Phone:603-436-0854
Mailing Address - Fax:603-431-8186
Practice Address - Street 1:278 LAFAYETTE RD
Practice Address - Street 2:BLDG E
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5455
Practice Address - Country:US
Practice Address - Phone:603-436-0854
Practice Address - Fax:603-431-8186
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2013-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH768103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH40008818Medicaid
NHRE4020Medicare ID - Type Unspecified