Provider Demographics
NPI:1962743542
Name:COVINGTON, JAMIE D (MA, LMHC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:D
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:902 W RIVERSIDE DR
Mailing Address - Street 2:
Mailing Address - City:CARLSBAD
Mailing Address - State:NM
Mailing Address - Zip Code:88220
Mailing Address - Country:US
Mailing Address - Phone:575-361-5185
Mailing Address - Fax:575-288-2794
Practice Address - Street 1:411 N CANYON ST
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:NM
Practice Address - Zip Code:88220
Practice Address - Country:US
Practice Address - Phone:575-361-5185
Practice Address - Fax:575-288-2794
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-07
Last Update Date:2015-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0156971101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health