Individual
MICHAEL GRIFFITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.S.S.W., LICSW
Contact information
Practice address
1095 MIDWAY RD, MENASHA, WI 54952-1115
(920) 720-2300
(920) 720-3719
Mailing address
122 E COLLEGE AVE, APPLETON, WI 54911-5794
(920) 996-3264
(920) 830-5910
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
10360
MN
1041C0700X
Clinical Social Worker
Primary
823-123
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
95D75GR
BLUECROSS/BLUESHIELD ID
MN
Enumeration date
05/16/2006
Last updated
03/17/2018
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