Nova M. Griffith, Ph.d., Psychological Services Llc | |
121 N 13th St Ste 2 Herrin IL 62948-3255 | |
(618) 969-2922 | |
Not Available |
Full Name | Nova M. Griffith, Ph.d., Psychological Services Llc |
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Speciality | Psychologist |
Location | 121 N 13th St Ste 2, Herrin, Illinois |
Authorized Official Name and Position | Nova M Griffith (OWNER,LIC. CLINICAL PSYCHOLOGIST) |
Authorized Official Contact | 6189692922 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Nova M. Griffith, Ph.d., Psychological Services Llc 400 E 8th St Johnston City IL 62951-1539 Ph: (618) 696-2922 | Nova M. Griffith, Ph.d., Psychological Services Llc 121 N 13th St Ste 2 Herrin IL 62948-3255 Ph: (618) 969-2922 |
NPI Number | 1639688724 |
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Provider Enumeration Date | 09/21/2017 |
Last Update Date | 02/05/2021 |
Certification Date | 02/05/2021 |
Medicare PECOS PAC ID | 4183970841 |
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Medicare Enrollment ID | O20180711000001 |
Identifier | Type | State | Issuer |
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1639688724 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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103TC0700X | Psychologist - Clinical | 071007669 (Illinois) | Primary |
Provider Name | Nova M Griffith |
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Provider Type | Practitioner - Clinical Psychologist |
Provider Identifiers | NPI Number: 1245598226 PECOS PAC ID: 6901152669 Enrollment ID: I20180711000014 |
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