Provider Demographics
NPI:1730707209
Name:GRIGGS, SARAH (CSW)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:GRIGGS
Suffix:
Gender:F
Credentials:CSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 W 1400 N APT 101
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:UT
Mailing Address - Zip Code:84341-7089
Mailing Address - Country:US
Mailing Address - Phone:719-210-6556
Mailing Address - Fax:
Practice Address - Street 1:277 N SPRING CREEK PKWY
Practice Address - Street 2:
Practice Address - City:PROVIDENCE
Practice Address - State:UT
Practice Address - Zip Code:84332-9775
Practice Address - Country:US
Practice Address - Phone:435-753-0253
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-10
Last Update Date:2020-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health