Healthcare Provider Details

I. General information

NPI: 1376811513
Provider Name (Legal Business Name): STACY L. COVINGTON MA; LPC;LCDC-I
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 10/08/2025
Certification Date: 10/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9403 SAN DIEGO RD
AUSTIN TX
78737-3035
US

IV. Provider business mailing address

9403 SAN DIEGO RD
AUSTIN TX
78737-3035
US

V. Phone/Fax

Practice location:
  • Phone: 512-829-1333
  • Fax:
Mailing address:
  • Phone: 512-829-1333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number63929
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: