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General NPI Number Information
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NPI Number | 1447168562
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Entity Type | Organization
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Legal Business Name | COVINGTON CLINIC LLC
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 318 4TH ST
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City | COVINGTON
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State | IN
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Zip | 47932-1225
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Country | US
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Telephone | 217-637-5172
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Fax |
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Provider Business Mailing Address
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Address Line | 318 4TH ST STE B
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City | COVINGTON
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State | IN
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Zip | 47932-1275
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Country | US
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Telephone | 217-637-5172
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JESSICA NEMECZ
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Credential | LCPC, LMHC
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Telephone | 217-637-5172
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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