Healthcare Provider Details

I. General information

NPI: 1962743542
Provider Name (Legal Business Name): JAMIE D. COVINGTON M.A., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/07/2013
Last Update Date: 10/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 N CANYON ST
CARLSBAD NM
88220
US

IV. Provider business mailing address

902 W RIVERSIDE DR
CARLSBAD NM
88220
US

V. Phone/Fax

Practice location:
  • Phone: 575-361-5185
  • Fax: 575-288-2794
Mailing address:
  • Phone: 575-361-5185
  • Fax: 575-288-2794

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number0156971
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: