Organization Active NPI

Desiree Griffin, M.S., LMHC

  • Mental Health Counselor
  • Fleming Island, FL
National Provider Identifier
1326405184
Registry record updated Jan 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH4968 Issued in FL
Legal business name
DESIREE GRIFFIN, M.S., LMHC
Practice address
4609 US Highway 17
Suite 1
Fleming Island, FL 32003-4818
Phone
(904) 759-7462
Fax
(904) 269-0021
NPI assigned
Jan 25, 2016
Last updated
Jan 26, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Ms. Desiree Ann Griffin, M.S.NPI 1336332824
Title
LMHC
Phone
(904) 759-7462

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH4968 FL Primary

Addresses

Primary practice location

4609 US Highway 17
Suite 1
Fleming Island, FL 32003-4818

Mailing address

4609 US Highway 17
Suite 1
Fleming Island, FL 32003-4818
Phone (904) 759-7462

Other identifiers 3

IdentifierTypeStateIssuer
11850334OtherFLCAQH
Z011HOtherFLBCBS
763896500MedicaidFL

National Provider Directory

National Provider Directory

Locations

4609 US Highway 17
Ste 1
Fleming Isle, FL 32003
Phone (904) 214-5109

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1453680000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1453766400000",
    "number": "1326405184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4609 US HIGHWAY 17",
            "address_2": "SUITE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034818",
            "telephone_number": "904-759-7462",
            "fax_number": "904-269-0021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4609 US HIGHWAY 17",
            "address_2": "SUITE 1",
            "city": "FLEMING ISLAND",
            "state": "FL",
            "postal_code": "320034818",
            "telephone_number": "904-759-7462",
            "fax_number": "904-269-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DESIREE GRIFFIN, M.S., LMHC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-01-25",
        "last_updated": "2016-01-26",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "DESIREE",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "LMHC",
        "authorized_official_telephone_number": "904-759-7462",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH4968",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH",
            "identifier": "11850334",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "Z011H",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "763896500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fleming Island, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.