Provider Demographics
NPI:1366690406
Name:CARRINGTON, MARIA THERESA (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:THERESA
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:THERESA
Other - Last Name:DVEIRIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:3318 BRIDGEPORT WAY W STE C
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-7854
Mailing Address - Country:US
Mailing Address - Phone:253-426-0763
Mailing Address - Fax:
Practice Address - Street 1:3318 BRIDGEPORT WAY W STE C
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-7854
Practice Address - Country:US
Practice Address - Phone:253-426-0763
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-03
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2152101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical