Healthcare Provider Details

I. General information

NPI: 1194116269
Provider Name (Legal Business Name): TERRI COVINGTON MHPP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/11/2015
Last Update Date: 12/18/2025
Certification Date: 12/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

204 N RHODES ST
WEST MEMPHIS AR
72301-3944
US

IV. Provider business mailing address

PO BOX 11064
FAYETTEVILLE AR
72703-1001
US

V. Phone/Fax

Practice location:
  • Phone: 870-400-8080
  • Fax: 870-400-8079
Mailing address:
  • Phone: 870-520-5014
  • Fax: 870-520-5015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: