Provider Demographics
NPI:1215748058
Name:COVERT, CONSTANCE (LCSW)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:
Last Name:COVERT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1812 STATE ROUTE 14A
Mailing Address - Street 2:
Mailing Address - City:PENN YAN
Mailing Address - State:NY
Mailing Address - Zip Code:14527-9381
Mailing Address - Country:US
Mailing Address - Phone:315-246-0441
Mailing Address - Fax:
Practice Address - Street 1:1120 OLD PINES TRL
Practice Address - Street 2:
Practice Address - City:PENN YAN
Practice Address - State:NY
Practice Address - Zip Code:14527-1421
Practice Address - Country:US
Practice Address - Phone:315-246-0441
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097002-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical