Provider Demographics
NPI:1881869766
Name:GRIFFIN, LEANNA (LPC)
Entity type:Individual
Prefix:
First Name:LEANNA
Middle Name:
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 S GLENSTONE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65804-0313
Mailing Address - Country:US
Mailing Address - Phone:417-862-8282
Mailing Address - Fax:417-862-8805
Practice Address - Street 1:1111 S GLENSTONE AVE STE 201
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65804-0313
Practice Address - Country:US
Practice Address - Phone:417-862-8282
Practice Address - Fax:417-862-8805
Is Sole Proprietor?:No
Enumeration Date:2008-04-23
Last Update Date:2008-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2005041270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health