Erica R. Griffin LLC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LPC007543 Issued in GA

Legal business name

ERICA R. GRIFFIN LLC

Practice address

561 Poole Melton Rd
Blythe, GA 30805-3813

Phone

(773) 954-5022

NPI assigned

Aug 20, 2015

Last updated

Aug 20, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Erica R Griffin, LPC

Title

Owner

Phone

(773) 954-5022

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1356717797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 POOLE MELTON RD",
            "city": "BLYTHE",
            "state": "GA",
            "postal_code": "308053813",
            "telephone_number": "773-954-5022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 POOLE MELTON RD",
            "city": "BLYTHE",
            "state": "GA",
            "postal_code": "308053813",
            "telephone_number": "773-954-5022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ERICA R. GRIFFIN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "GRIFFIN",
        "authorized_official_first_name": "ERICA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "773-954-5022",
        "authorized_official_credential": "LPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC007543",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003144054A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Professional Counselor in Blythe, GA
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• Professional Counselor in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2015; 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.