Healthcare Provider Details

I. General information

NPI: 1992636906
Provider Name (Legal Business Name): DOMINIQUE COVINGTON LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11444 LELAND PL
WALDORF MD
20601-4955
US

IV. Provider business mailing address

11444 LELAND PL
WALDORF MD
20601-4955
US

V. Phone/Fax

Practice location:
  • Phone: 202-550-1341
  • Fax:
Mailing address:
  • Phone: 202-550-1341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberPRC200012662
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: