Provider Demographics
NPI:1447399878
Name:GARRINGER, TRACI RENEE (LCSW)
Entity Type:Individual
Prefix:
First Name:TRACI
Middle Name:RENEE
Last Name:GARRINGER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 PINE CONE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNTAIN HOME
Mailing Address - State:AR
Mailing Address - Zip Code:72653-8892
Mailing Address - Country:US
Mailing Address - Phone:870-425-9348
Mailing Address - Fax:
Practice Address - Street 1:15 E 5TH ST
Practice Address - Street 2:
Practice Address - City:MOUNTAIN HOME
Practice Address - State:AR
Practice Address - Zip Code:72653-3809
Practice Address - Country:US
Practice Address - Phone:870-425-2030
Practice Address - Fax:870-425-7030
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2018-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR4033-C101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health