TINA M GRIFFITH
NPI 1063072585
Counselor - Professional in Green Bay, WI

Q: What is Tina Griffith's NPI number?

The NPI number for Tina Griffith is 1063072585. It was assigned to this individual provider in the NPPES registry on June 17, 2019.

Q: What is Tina Griffith's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Q: When was this NPI record last updated?

The NPPES record for Tina Griffith was last updated on August 11, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since June 17, 2019PECOS EnrolledAccepts Medicare Assignment

2640 W POINT RD, GREEN BAY, WI 54304(920) 490-3790 Get Directions Write a Review

NPPES record last updated: August 11, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 11, 2022, Jun 17, 2019 (2 updates tracked since 2019).

On this page

About Tina M Griffith NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TINA M GRIFFITH (NPI 1063072585) is an individual professional provider in Green Bay, Wisconsin, licensed in Wisconsin (7209) and active in the NPI registry since June 2019. She is enrolled in Medicare PECOS, maintains a secondary practice location in Oshkosh, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1063072585

Entity TypeIndividualFemale

Primary Taxonomy101YP2500X

Provider Legal NameTINA M GRIFFITH

Location Address2640 W POINT RDGreen Bay, WI 54304-1344

Mailing AddressPo Box 365Oneida, WI 54155-0365 · (920) 490-3790

Phone(920) 490-3790

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateJune 17, 2019

Last NPPES UpdateAugust 11, 20222 updates tracked since enumeration

NPPES CertifiedAugust 11, 2022

✔ NPI 1063072585 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers

Taxonomy Code101YP2500X

License✔ Licensed in WI · 7209

2640 W POINT RD, Green Bay, WI 54304

Open in Google Maps ↗

Secondary Practice Location 1

Location 1600 N Westhaven DrOshkosh, WI 54904-6926 · Phone (920) 720-2300 · Fax (920) 237-5616

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource (Common Ground Healthcare), Medica and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Tina M Griffith is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID3779971106

PECOS Enrollment IDI20260223000685

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. SCOTT D LALONDE CSAC

Counselor (Addiction (Substance Use Disorder))