Provider Demographics
NPI:1568069029
Name:COVEY, BRANDON (LPCC)
Entity type:Individual
Prefix:
First Name:BRANDON
Middle Name:
Last Name:COVEY
Suffix:
Gender:M
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:624 MARKET AVE N
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44702-1017
Mailing Address - Country:US
Mailing Address - Phone:330-493-4553
Mailing Address - Fax:330-493-3761
Practice Address - Street 1:1844 W STATE ST
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-5771
Practice Address - Country:US
Practice Address - Phone:330-493-4553
Practice Address - Fax:330-493-3761
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC.2002740-TRNE101Y00000X
OHE.2404423101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor