Provider Demographics
NPI:1306911623
Name:COVENEY, BARBARA MILAZZO (LICSW)
Entity type:Individual
Prefix:MRS
First Name:BARBARA
Middle Name:MILAZZO
Last Name:COVENEY
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 GATES ROAD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MA
Mailing Address - Zip Code:01541
Mailing Address - Country:US
Mailing Address - Phone:978-464-5638
Mailing Address - Fax:
Practice Address - Street 1:CHARIS LIGHTHOUSE COUNSELING
Practice Address - Street 2:61 BOYDEN ROAD
Practice Address - City:HOLDEN
Practice Address - State:MA
Practice Address - Zip Code:01520
Practice Address - Country:US
Practice Address - Phone:508-890-0330
Practice Address - Fax:774-642-0017
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1052291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP03766Medicare ID - Type Unspecified