Provider Demographics
NPI:1356757678
Name:ARRINGTON, MAE GRACE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MAE
Middle Name:GRACE
Last Name:ARRINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MAE
Other - Middle Name:
Other - Last Name:ARRINGTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:CADC
Mailing Address - Street 1:4579 S EASON BLVD
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6539
Mailing Address - Country:US
Mailing Address - Phone:662-377-3161
Mailing Address - Fax:662-377-7595
Practice Address - Street 1:4428 S EASON BLVD STE B
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6506
Practice Address - Country:US
Practice Address - Phone:662-234-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-08
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAD89-004A101YA0400X
MSC66621041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)