Individual provider Active NPI

Shamijah Griffin

  • Mental Health Counselor
  • Bastrop, LA
National Provider Identifier
1568201937
Registry record updated May 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
2203784997 Issued in LA
Practice address
343 N Washington St
Bastrop, LA 71220-3849
Phone
(318) 974-5075
NPI assigned
May 23, 2024
Last updated
May 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 2203784997 LA Primary

Addresses

Primary practice location

343 N Washington St
Bastrop, LA 71220-3849

Mailing address

343 N Washington St
Bastrop, LA 71220-3849
Phone (318) 974-5075

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
2203784997LAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Counseling, LLC CurrentSince May 26, 2024 Accepting new patients
Total Wellness Urgent Psychiatric Care Clinic CurrentSince May 26, 2024 Accepting new patients

Locations

343 N Washington St
Bastrop, LA 71220
Phone (318) 598-5040

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1716422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716422400000",
    "number": "1568201937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "343 N WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712203849",
            "telephone_number": "318-974-5075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "343 N WASHINGTON ST",
            "city": "BASTROP",
            "state": "LA",
            "postal_code": "712203849",
            "telephone_number": "318-974-5075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIFFIN",
        "first_name": "SHAMIJAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-23",
        "last_updated": "2024-05-23",
        "certification_date": "2024-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "LA",
            "license": "2203784997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bastrop, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2024; 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.