Provider Demographics
NPI:1528838794
Name:GRIFFIN, CHARITY BROWN (PHD)
Entity type:Individual
Prefix:DR
First Name:CHARITY
Middle Name:BROWN
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:413 WESLEY PARK DR
Mailing Address - Street 2:
Mailing Address - City:KERNERSVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27284-2127
Mailing Address - Country:US
Mailing Address - Phone:336-848-7823
Mailing Address - Fax:
Practice Address - Street 1:4160 PIEDMONT PKWY STE 207
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27410-8174
Practice Address - Country:US
Practice Address - Phone:336-855-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-08
Last Update Date:2024-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5135103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool