Provider Demographics
NPI:1528743614
Name:GRIFFIN, ERICA CAMERON (LMHC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:CAMERON
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:ERICA
Other - Middle Name:CAMERON
Other - Last Name:SHELLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:336 LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:VALPARAISO
Mailing Address - State:FL
Mailing Address - Zip Code:32580-1260
Mailing Address - Country:US
Mailing Address - Phone:850-449-2390
Mailing Address - Fax:
Practice Address - Street 1:336 LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:VALPARAISO
Practice Address - State:FL
Practice Address - Zip Code:32580-1260
Practice Address - Country:US
Practice Address - Phone:850-449-2390
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-06-16
Last Update Date:2023-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH14059101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health