Basic Information
| Provider Information | |||||||||
| NPI: | 1508864943 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GRIFFITH | ||||||||
| FirstName: | RODNEY | ||||||||
| MiddleName: | BRUCE | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | L.P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1241 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404341941 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1241 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | HARRISONBURG | ||||||||
| State: | VA | ||||||||
| PostalCode: | 228024632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5404341941 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/11/2005 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101Y00000X | 0701003771 | VA | X | Behavioral Health & Social Service Providers | Counselor | 101YA0400X | 0701003771 | VA | X | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) | 101YP2500X | 0701003771 | VA | X | Behavioral Health & Social Service Providers | Counselor | Professional |
ID Information
| ID | Type | State | Issuer | Description | 175238 | 01 | VA | ANTHEM BC/BS | OTHER | 082962M | 01 | VA | SENTARAL OPTIMA | OTHER |