Provider Demographics
NPI:1851837850
Name:GRIFFITH, JENNIFER HASTINGS (LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:HASTINGS
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:MARI
Other - Last Name:HASTINGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9712 FAIR OAKS BLVD STE C1
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-7032
Mailing Address - Country:US
Mailing Address - Phone:406-838-3599
Mailing Address - Fax:
Practice Address - Street 1:9712 FAIR OAKS BLVD STE C1
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-7032
Practice Address - Country:US
Practice Address - Phone:406-838-3599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-13
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA133010106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist