Provider Demographics
NPI:1366955619
Name:GRIFFIN, KATLYN H (LPC, LMHC)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:H
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LPC, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1100 HIGH RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06905-1222
Mailing Address - Country:US
Mailing Address - Phone:914-417-1406
Mailing Address - Fax:
Practice Address - Street 1:1100 HIGH RIDGE RD STE 206A
Practice Address - Street 2:
Practice Address - City:STAMFORD
Practice Address - State:CT
Practice Address - Zip Code:06905-1201
Practice Address - Country:US
Practice Address - Phone:914-417-1406
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-08
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY8047101YM0800X
CT3170101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health