Provider Demographics
NPI:1881571321
Name:GRIFFIN, JESSICA TILSON (LCHMCA)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:TILSON
Last Name:GRIFFIN
Suffix:
Gender:F
Credentials:LCHMCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1238 PLEASANT RIDGE RD APT 3E
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27409-0054
Mailing Address - Country:US
Mailing Address - Phone:828-200-1361
Mailing Address - Fax:
Practice Address - Street 1:381 S SWING RD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27409-2009
Practice Address - Country:US
Practice Address - Phone:336-864-5435
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-18
Last Update Date:2025-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor