Provider Demographics
NPI:1215641824
Name:SOBOL, GRIFFIN CHARLES (MA)
Entity type:Individual
Prefix:
First Name:GRIFFIN
Middle Name:CHARLES
Last Name:SOBOL
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:ADRIAN
Mailing Address - State:MI
Mailing Address - Zip Code:49221-2132
Mailing Address - Country:US
Mailing Address - Phone:815-342-0580
Mailing Address - Fax:
Practice Address - Street 1:600 N BROAD ST
Practice Address - Street 2:
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-2132
Practice Address - Country:US
Practice Address - Phone:815-342-0580
Practice Address - Fax:517-759-3939
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-09
Last Update Date:2023-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor