Provider Demographics
NPI:1992450597
Name:CARRINGTON, LEVON (CAC-AD)
Entity type:Individual
Prefix:
First Name:LEVON
Middle Name:
Last Name:CARRINGTON
Suffix:
Gender:M
Credentials:CAC-AD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CLIPPER RD
Mailing Address - Street 2:
Mailing Address - City:ESSEX
Mailing Address - State:MD
Mailing Address - Zip Code:21221-7009
Mailing Address - Country:US
Mailing Address - Phone:443-473-5283
Mailing Address - Fax:
Practice Address - Street 1:47 CLIPPER RD
Practice Address - Street 2:
Practice Address - City:ESSEX
Practice Address - State:MD
Practice Address - Zip Code:21221-7009
Practice Address - Country:US
Practice Address - Phone:443-473-5283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-14
Last Update Date:2022-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDAC2548101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)