1730324773 NPI number — MS. CHRISTY MAURINE GRIFFIN L.C.S.W.

Table of content: MS. CHRISTY MAURINE GRIFFIN L.C.S.W. (NPI 1730324773)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1730324773 NPI number — MS. CHRISTY MAURINE GRIFFIN L.C.S.W.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GRIFFIN
Provider First Name:
CHRISTY
Provider Middle Name:
MAURINE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
L.C.S.W.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FOUNTAIN
Provider Other First Name:
CHRISTY
Provider Other Middle Name:
MAURINE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
5

NPI Number Information

NPI Number:
1730324773
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/04/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
11378 EATON STREET
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTMINSTER
Provider Business Mailing Address State Name:
CO
Provider Business Mailing Address Postal Code:
80020-6869
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
720-323-1536
Provider Business Mailing Address Fax Number:
303-467-4097

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
536 COLORADO BOULEVARD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DACONO
Provider Business Practice Location Address State Name:
CO
Provider Business Practice Location Address Postal Code:
80514
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
720-323-1536
Provider Business Practice Location Address Fax Number:
303-467-4097
Provider Enumeration Date:
12/04/2008

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: 1041C0700X , with the licence number:  635 , registered in the state of CO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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