Provider Demographics
NPI:1144459603
Name:GRIGGS, JILL H (MA, LPCC, NCC)
Entity type:Individual
Prefix:MS
First Name:JILL
Middle Name:H
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:MA, LPCC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1380 RIO RANCHO DR SE # 432
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-1006
Mailing Address - Country:US
Mailing Address - Phone:505-565-7949
Mailing Address - Fax:877-440-8944
Practice Address - Street 1:750 BROADMOOR BLVD NE STE E
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-3442
Practice Address - Country:US
Practice Address - Phone:505-655-7949
Practice Address - Fax:877-440-8944
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-06
Last Update Date:2022-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCCMH0158231101YP2500X
NM0158231101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM97739260Medicaid