Provider Demographics
NPI:1679961478
Name:GRIFFITH, CANDACE LEIGH (LMFT)
Entity type:Individual
Prefix:MS
First Name:CANDACE
Middle Name:LEIGH
Last Name:GRIFFITH
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:402 CORDER RD STE 200
Mailing Address - Street 2:
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-7165
Mailing Address - Country:US
Mailing Address - Phone:478-551-4714
Mailing Address - Fax:478-445-4963
Practice Address - Street 1:402 CORDER RD STE 200
Practice Address - Street 2:
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-7165
Practice Address - Country:US
Practice Address - Phone:478-551-4714
Practice Address - Fax:478-551-4718
Is Sole Proprietor?:No
Enumeration Date:2014-12-31
Last Update Date:2022-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMFT001020106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist