Provider Demographics
NPI:1104272418
Name:GRIFFIN LYONS COUNSELING LLC
Entity type:Organization
Organization Name:GRIFFIN LYONS COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:T
Authorized Official - Last Name:BODDIE
Authorized Official - Suffix:JR
Authorized Official - Credentials:LCSW
Authorized Official - Phone:502-385-2748
Mailing Address - Street 1:306 W MAIN ST
Mailing Address - Street 2:STE 501
Mailing Address - City:FRANKFORT
Mailing Address - State:KY
Mailing Address - Zip Code:40601-1895
Mailing Address - Country:US
Mailing Address - Phone:502-385-2748
Mailing Address - Fax:502-996-8400
Practice Address - Street 1:306 W MAIN ST
Practice Address - Street 2:STE 501
Practice Address - City:FRANKFORT
Practice Address - State:KY
Practice Address - Zip Code:40601-1895
Practice Address - Country:US
Practice Address - Phone:502-385-2748
Practice Address - Fax:502-996-8400
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-05
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty