Provider Demographics
NPI:1912269028
Name:CRIFFIELD, CHANDRA LYNNE DOORN (LMSW)
Entity type:Individual
Prefix:
First Name:CHANDRA
Middle Name:LYNNE DOORN
Last Name:CRIFFIELD
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:CHANDRA
Other - Middle Name:LYNNE
Other - Last Name:DOORN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW
Mailing Address - Street 1:5951 STONYHILL LN SE
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-6462
Mailing Address - Country:US
Mailing Address - Phone:616-706-9223
Mailing Address - Fax:
Practice Address - Street 1:5951 STONYHILL LN SE
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-6462
Practice Address - Country:US
Practice Address - Phone:616-706-9223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2021-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010877061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical