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General NPI Number Information
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NPI Number | 1043894124
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Entity Type | Organization
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Legal Business Name | COVINGTON WELLNESS CENTER LLC
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Dates
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Enumeration Date | 05/05/2021
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Last Update Date | 08/19/2025
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Provider Practice Location Address
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Address Line | 350 HOUBOLT RD STE 210
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City | JOLIET
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State | IL
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Zip | 60431-8305
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Country | US
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Telephone | 815-869-7956
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Fax |
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Provider Business Mailing Address
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Address Line | 8305 FOXBOROUGH WAY
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City | JOLIET
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State | IL
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Zip | 60431-7806
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Country | US
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Telephone | 815-869-7956
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Fax |
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Authorized Official
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Title or Position | CLINICAL THERAPIST
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Name | KATRINA COVINGTON
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Credential | LCPC, LCMHC
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Telephone | 910-787-0938
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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