Provider Demographics
NPI:1962105791
Name:COVINGTON, TOSHA C (LCDC)
Entity type:Individual
Prefix:
First Name:TOSHA
Middle Name:C
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:LCDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 SCENIC HARBOUR DR
Mailing Address - Street 2:
Mailing Address - City:LAKEHILLS
Mailing Address - State:TX
Mailing Address - Zip Code:78063-6524
Mailing Address - Country:US
Mailing Address - Phone:210-232-4197
Mailing Address - Fax:
Practice Address - Street 1:200 SCENIC HARBOUR DR
Practice Address - Street 2:
Practice Address - City:LAKEHILLS
Practice Address - State:TX
Practice Address - Zip Code:78063-6524
Practice Address - Country:US
Practice Address - Phone:210-232-4197
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-22
Last Update Date:2023-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX16446101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)