Provider Demographics
NPI:1225376023
Name:COVINGTON, LESLIE R (MSW, LCSWA)
Entity Type:Individual
Prefix:MS
First Name:LESLIE
Middle Name:R
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 SIMMONS ST
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27701-4334
Mailing Address - Country:US
Mailing Address - Phone:919-530-8755
Mailing Address - Fax:919-530-8766
Practice Address - Street 1:510 SIMMONS ST
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27701-4334
Practice Address - Country:US
Practice Address - Phone:919-530-8755
Practice Address - Fax:919-530-8766
Is Sole Proprietor?:No
Enumeration Date:2013-01-29
Last Update Date:2013-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
P0074671041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical