1386808517 NPI number — MRS. CARON GIVHAN GRIFFIN MSW

Table of content: MRS. CARON GIVHAN GRIFFIN MSW (NPI 1386808517)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386808517 NPI number — MRS. CARON GIVHAN GRIFFIN MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
CARON
Provider Middle Name:
GIVHAN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PETTAWAY
Provider Other First Name:
CARON
Provider Other Middle Name:
GIVHAN
Provider Other Name Prefix Text:
MRS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1386808517
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/16/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
975 9TH AVE SW
Provider Second Line Business Mailing Address:
SUITE 400
Provider Business Mailing Address City Name:
BESSEMER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35022-7837
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-428-3495
Provider Business Mailing Address Fax Number:
205-428-9240

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
975 9TH AVE. S.W.
Provider Second Line Business Practice Location Address:
SUITE 400
Provider Business Practice Location Address City Name:
BESSEMER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35022
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-428-3495
Provider Business Practice Location Address Fax Number:
205-428-9240
Provider Enumeration Date:
07/16/2008

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 104100000X , with the licence number:  N/A ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)