Provider Demographics
NPI:1568050789
Name:CARRINGTON, MEGHAN GOTTUNG (LISW-CP)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:GOTTUNG
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:LISW-CP
Other - Prefix:
Other - First Name:MEGHAN
Other - Middle Name:ELISE
Other - Last Name:GOTTUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:4897 VILLAGE CREEK DR
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-5148
Mailing Address - Country:US
Mailing Address - Phone:678-773-9664
Mailing Address - Fax:
Practice Address - Street 1:4897 VILLAGE CREEK DR
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-5148
Practice Address - Country:US
Practice Address - Phone:678-773-9664
Practice Address - Fax:888-316-7716
Is Sole Proprietor?:No
Enumeration Date:2021-01-04
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC122141041C0700X
GACSW0082711041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical