Provider Demographics
NPI:1063847176
Name:ARRINGTON, LILLIE FAYE (MED)
Entity Type:Individual
Prefix:MS
First Name:LILLIE
Middle Name:FAYE
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 MEADOW LANDING LN
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37743-3133
Mailing Address - Country:US
Mailing Address - Phone:423-327-0035
Mailing Address - Fax:
Practice Address - Street 1:108 MEADOW LANDING LN
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37743-3133
Practice Address - Country:US
Practice Address - Phone:423-327-0035
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-09
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN1-01-0381103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN00C40Medicaid