Healthcare Provider Details

I. General information

NPI: 1508506791
Provider Name (Legal Business Name): COURTNEY COVINGTON RBT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SHOPPERS DR
WINCHESTER KY
40391-1380
US

IV. Provider business mailing address

133 MADISON RIVER RD APT 104
LEXINGTON KY
40511-6537
US

V. Phone/Fax

Practice location:
  • Phone: 859-353-5445
  • Fax:
Mailing address:
  • Phone: 859-353-5445
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number310216
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: