Healthcare Provider Details

I. General information

NPI: 1326154030
Provider Name (Legal Business Name): CAROL JONELL ARRINGTON MMFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/23/2006
Last Update Date: 01/16/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 NORTH ST
NACOGDOCHES TX
75961-4479
US

IV. Provider business mailing address

903 NORTH ST
NACOGDOCHES TX
75961-4479
US

V. Phone/Fax

Practice location:
  • Phone: 936-639-6512
  • Fax: 936-639-2302
Mailing address:
  • Phone: 936-564-4064
  • Fax: 936-564-1570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number005044-042364
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5044
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: