Provider Demographics
NPI:1801003116
Name:GRIFFIN, SANDRA KAY (LCSW)
Entity type:Individual
Prefix:
First Name:SANDRA
Middle Name:KAY
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4770 E. ILLIFF AVE.
Mailing Address - Street 2:SUITE 111
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80222
Mailing Address - Country:US
Mailing Address - Phone:303-759-1505
Mailing Address - Fax:303-681-3362
Practice Address - Street 1:4770 E ILIFF AVE
Practice Address - Street 2:SUITE 111
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80222-6061
Practice Address - Country:US
Practice Address - Phone:303-759-1505
Practice Address - Fax:303-681-3362
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO989609101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO989609OtherLICENSED SOCIAL WORKER