Healthcare Provider Details

I. General information

NPI: 1386558534
Provider Name (Legal Business Name): BRIANNE NOE COVINGTON LGPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7401 FORBES BLVD
LANHAM MD
20706-2200
US

IV. Provider business mailing address

9630 MILESTONE WAY
COLLEGE PARK MD
20740-4285
US

V. Phone/Fax

Practice location:
  • Phone: 240-398-1350
  • Fax:
Mailing address:
  • Phone: 304-350-2103
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLGP18597
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: