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NPI Code Detail

MEDICARE: MRS. OLIVIA GRACE COVERT LPC

MEDICARE: MRS. OLIVIA GRACE COVERT LPC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorC.2002475-TRNEOH
2101YM0800XMental Health CounselorC.2002475OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1366065732
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. OLIVIA GRACE COVERT LPC
Provider Business Mailing Address
First Line : 1066 LEXINGTON AVENUE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2250
Country : US
Telephone Number : 419-526-5523
Fax Number : 419-526-5525
Provider Business Practice Location Address
First Line : 1066 LEXINGTON AVENUE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-2250
Country : US
Telephone Number : 419-526-5523
Fax Number : 419-526-5525
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2020
Last Update Date : 07/11/2023

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