Healthcare Provider Details
I. General information
NPI: 1720993686
Provider Name (Legal Business Name): COVENANT LEGACY COUNSELING GROUP, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/17/2026
Last Update Date: 08/17/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2 CARDENTI CT
NEWARK DE
19702
US
IV. Provider business mailing address
4 PEDDLERS ROW UNIT 146
NEWARK DE
19702-1525
US
V. Phone/Fax
- Phone: 302-894-8103
- Fax:
- Phone: 302-894-8103
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 101YM0800X |
| Taxonomy | Mental Health Counselor |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
JOSLYNN
ALSTON
Title or Position: CEO & CLINICAL DIRECTOR
Credential: LPCMH
Phone: 302-894-8103