Healthcare Provider Details

I. General information

NPI: 1346779170
Provider Name (Legal Business Name): TITUS COVINGTON LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/06/2017
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

501 DARBY CREEK RD STE 40
LEXINGTON KY
40509-1671
US

IV. Provider business mailing address

1675 KILKENNY DR
LEXINGTON KY
40505-2316
US

V. Phone/Fax

Practice location:
  • Phone: 859-433-0762
  • Fax:
Mailing address:
  • Phone: 859-230-1939
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLCSW00001791
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: