Provider Demographics
NPI:1356672851
Name:KOVACS, ELIZABETH WILEY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:WILEY
Last Name:KOVACS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 435
Mailing Address - Street 2:
Mailing Address - City:DAVIDSON
Mailing Address - State:NC
Mailing Address - Zip Code:28036-0435
Mailing Address - Country:US
Mailing Address - Phone:704-966-9277
Mailing Address - Fax:980-217-8402
Practice Address - Street 1:18139 W CATAWBA AVE STE 2
Practice Address - Street 2:
Practice Address - City:CORNELIUS
Practice Address - State:NC
Practice Address - Zip Code:28031-5641
Practice Address - Country:US
Practice Address - Phone:704-966-9277
Practice Address - Fax:980-217-8402
Is Sole Proprietor?:No
Enumeration Date:2010-01-22
Last Update Date:2019-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0084001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical