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2421 Allentown Rd Lima OH 45805-1711 | |
| (419) 225-5238 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Psychologist |
| Location | 2421 Allentown Rd, Lima, Ohio |
| Authorized Official Name and Position | Michael D. Griffith (OWNER/CLINICAL PSYCHOLOGIST) |
| Authorized Official Contact | 4192255238 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
2421 Allentown Rd Lima OH 45805-1711 Ph: (419) 225-5238 | 2421 Allentown Rd Lima OH 45805-1711 Ph: (419) 225-5238 |
| NPI Number | 1265604912 |
|---|---|
| Provider Enumeration Date | 04/01/2008 |
| Last Update Date | 06/06/2013 |
| Medicare PECOS PAC ID | 1456259753 |
|---|---|
| Medicare Enrollment ID | O20080723000528 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265604912 | NPI | - | NPPES |
| 2976481 | Medicaid | OH |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 4813 (Ohio) | Primary |
| Provider Name | Michael Griffith |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1063684892 PECOS PAC ID: 5193623007 Enrollment ID: I20040115000000 |
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