Provider Demographics
NPI:1306927066
Name:EDINGTON, LARA LEE (MA)
Entity type:Individual
Prefix:
First Name:LARA
Middle Name:LEE
Last Name:EDINGTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9111 CROSS PARK DR
Mailing Address - Street 2:SUITE E-475
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37923-4506
Mailing Address - Country:US
Mailing Address - Phone:865-560-2550
Mailing Address - Fax:865-560-2580
Practice Address - Street 1:9111 CROSS PARK DR
Practice Address - Street 2:SUITE E-475
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37923-4506
Practice Address - Country:US
Practice Address - Phone:865-560-2550
Practice Address - Fax:865-560-2580
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2012-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health