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 1:711 ST HELENS AVE STE 103B
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98402-3736
Mailing Address - Country:US
Mailing Address - Phone:253-426-0763
Mailing Address - Fax:
Practice Address - Street 1:711 ST HELENS AVE STE 103B
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98402-3736
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:2024-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60308917101YM0800X
MA2152101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty