Provider Demographics
NPI:1699914101
Name:COVINGTON-THOMAS, CANDICE (JD, LCSW)
Entity type:Individual
Prefix:
First Name:CANDICE
Middle Name:
Last Name:COVINGTON-THOMAS
Suffix:
Gender:F
Credentials:JD, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 CLEVELAND AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:08904-1817
Mailing Address - Country:US
Mailing Address - Phone:732-963-7996
Mailing Address - Fax:732-360-0740
Practice Address - Street 1:317 CLEVELAND AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-1817
Practice Address - Country:US
Practice Address - Phone:732-963-7996
Practice Address - Fax:732-360-0740
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-08
Last Update Date:2021-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC052887001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical