Provider Demographics
NPI:1871708677
Name:GRIFFIN, TORRI L (PHD)
Entity type:Individual
Prefix:DR
First Name:TORRI
Middle Name:L
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 1:4519 LIONSHEAD CIR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30038-2288
Mailing Address - Country:US
Mailing Address - Phone:770-322-3439
Mailing Address - Fax:413-803-1756
Practice Address - Street 1:5300 MEMORIAL DR
Practice Address - Street 2:SUITE 115
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3148
Practice Address - Country:US
Practice Address - Phone:404-805-1756
Practice Address - Fax:413-083-1756
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-14
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC003723101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003125996AMedicaid