Provider Demographics
NPI:1225285026
Name:COVINGTON, LANA NICOLE (LCSW)
Entity Type:Individual
Prefix:
First Name:LANA
Middle Name:NICOLE
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:403 PRINCETON RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-2056
Mailing Address - Country:US
Mailing Address - Phone:423-773-2940
Mailing Address - Fax:
Practice Address - Street 1:403 PRINCETON RD
Practice Address - Street 2:SUITE #2
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37601-2056
Practice Address - Country:US
Practice Address - Phone:423-773-2940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-22
Last Update Date:2016-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040087471041C0700X
TNLSW00000062941041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical