Griffin, Jesse Lee

Griffin, Jesse Lee is an sole proprietor health care provider with primary practice located at 7700 Old Branch Ave Suite D103, Clinton MD 20735-1628. He recently has 3 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Pastoral, Behavioral Health & Social Service Providers / Professional. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Griffin, Jesse Lee can be contacted via phone (877) 214-3668.

Contact Information

Primary practice address
7700 Old Branch Ave Suite D103 Clinton MD 20735-1628
Phone: (877) 214-3668
Fax: (877) 599-2585
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LC3005
Behavioral Health & Social Service Providers / Pastoral 101YP1600X LC3005 Maryland
Behavioral Health & Social Service Providers / Professional 101YP2500X LC3005 Maryland
Behavioral Health & Social Service Providers / Professional 101YP2500X PRC14059 District of Columbia
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701004903 Virginia

Profile Details

NPI number 1639475031
LBN Legal business name Griffin, Jesse Lee
Credentials PHD, LCPC, NCC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 1st, 2011
Last updated Sep 20th, 2013 - about 11 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639475031 NPPES
Maryland MEDICAID 040066100

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