Provider Demographics
NPI:1922670439
Name:CARRINGTON, TENILLE L (CSW009285)
Entity type:Individual
Prefix:
First Name:TENILLE
Middle Name:L
Last Name:CARRINGTON
Suffix:
Gender:F
Credentials:CSW009285
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 WATSON PL
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-3262
Mailing Address - Country:US
Mailing Address - Phone:404-877-8718
Mailing Address - Fax:
Practice Address - Street 1:126 ENTERPRISE PATH STE 205
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-2654
Practice Address - Country:US
Practice Address - Phone:404-594-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-14
Last Update Date:2025-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAMSW009509104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker