Provider Demographics
NPI:1336288596
Name:COVEY, LINDA ARLINE (PHD)
Entity type:Individual
Prefix:DR
First Name:LINDA
Middle Name:ARLINE
Last Name:COVEY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:933 W GRAND RIVER
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:MI
Mailing Address - Zip Code:48895
Mailing Address - Country:US
Mailing Address - Phone:517-655-4198
Mailing Address - Fax:
Practice Address - Street 1:933 W GRAND RIVER
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:MI
Practice Address - Zip Code:48895-1209
Practice Address - Country:US
Practice Address - Phone:517-655-4198
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6301005024103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OM82530Medicare ID - Type Unspecified