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General NPI Number Information
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NPI Number | 1790167963
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Entity Type | Individual
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Provider Name | JAMIE KOVACS
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Gender | Female
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Dates
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Enumeration Date | 06/24/2015
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Last Update Date | 03/06/2022
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Provider Practice Location Address
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Address Line | 1635B TURNER ST
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City | CLEARWATER
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State | FL
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Zip | 33756-6245
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Country | US
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Telephone | 983-865-7520
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Fax |
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Provider Business Mailing Address
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Address Line | 626 LAKEVIEW RD STE B
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City | CLEARWATER
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State | FL
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Zip | 33756-3359
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Country | US
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Telephone | 973-865-7520
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | MH20233
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 103K00000X
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Taxonomy Name | Behavior Analyst
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License Number | BH000900
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC008691
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License Number State | PA
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