Individual
MR. DERRICK PRINGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
110 48TH AVE, MERIDIAN, MS 39307
(601) 513-4359
Mailing address
110 48TH AVE, MERIDIAN, MS 39307-6719
(601) 513-4359
(601) 485-2310
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
C7012
MS
1041C0700X
Clinical Social Worker
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8034
—
MS
Enumeration date
08/01/2017
Last updated
07/21/2022
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