Individual
JESSE LEE GRIFFIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, LCPC, NCC
Contact information
Practice address
7700 OLD BRANCH AVE, SUITE D103, CLINTON, MD 20735-1628
(877) 214-3668
(877) 599-2585
Mailing address
6368 COVENTRY WAY, #386, CLINTON, MD 20735-2256
(877) 214-3668
(877) 599-2585
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
LC3005
—
101YP1600X
Pastoral Counselor
LC3005
MD
101YP2500X
Professional Counselor
0701004903
VA
101YP2500X
Professional Counselor
LC3005
MD
101YP2500X
Professional Counselor
PRC14059
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040066100
—
MD
Enumeration date
02/01/2011
Last updated
09/20/2013
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