Healthcare Provider Details

I. General information

NPI: 1295111557
Provider Name (Legal Business Name): COVENANT COUNSELING & CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/09/2015
Last Update Date: 01/11/2023
Certification Date: 01/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 JOHNSTON ST SE STE 100
DECATUR AL
35601-2515
US

IV. Provider business mailing address

251 JOHNSTON ST SE STE 100
DECATUR AL
35601-2515
US

V. Phone/Fax

Practice location:
  • Phone: 256-822-2375
  • Fax: 256-584-2330
Mailing address:
  • Phone: 256-822-2375
  • Fax: 256-584-2330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2542
License Number StateAL
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3080
License Number StateAL
# 4
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. TRICIA M LANGENFELD
Title or Position: OFFICE MANAGER
Credential:
Phone: 256-822-2375