Healthcare Provider Details

I. General information

NPI: 1992726145
Provider Name (Legal Business Name): COVENANT COUNSELING CNTR
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2006
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

38 W BIG SPRING AVE
NEWVILLE PA
17241-1302
US

IV. Provider business mailing address

38 W BIG SPRING AVE
NEWVILLE PA
17241-1302
US

V. Phone/Fax

Practice location:
  • Phone: 717-776-3092
  • Fax:
Mailing address:
  • Phone: 717-776-3092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC000623
License Number StatePA

VIII. Authorized Official

Name: MARCIA J SINKOVITZ
Title or Position: LICENSED PROFESSIONAL COUNSELOR
Credential: MS
Phone: 717-776-3092