Provider Demographics
NPI:1235972571
Name:GRIGGS, JOHN C JR
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:GRIGGS
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6603 IRONGATE SQ
Mailing Address - Street 2:
Mailing Address - City:NORTH CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23234-6081
Mailing Address - Country:US
Mailing Address - Phone:804-743-0960
Mailing Address - Fax:
Practice Address - Street 1:6603 IRONGATE SQ
Practice Address - Street 2:
Practice Address - City:NORTH CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23234-6081
Practice Address - Country:US
Practice Address - Phone:804-743-0960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-14
Last Update Date:2024-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0906015159104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker