Healthcare Provider Details

I. General information

NPI: 1437714680
Provider Name (Legal Business Name): MARK C COVINGTON JR. MA, NCC, LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/03/2019
Last Update Date: 07/24/2024
Certification Date: 07/24/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1755 S ST NW STE 6
WASHINGTON DC
20009-6107
US

IV. Provider business mailing address

1160 1ST ST NE APT 1212
WASHINGTON DC
20002-4873
US

V. Phone/Fax

Practice location:
  • Phone: 202-234-7738
  • Fax:
Mailing address:
  • Phone: 336-816-3627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC15171
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: