Provider Demographics
NPI:1437315348
Name:COVINGTON, JERRY S (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JERRY
Middle Name:S
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1602 ROWEMONT DR
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27705-2176
Mailing Address - Country:US
Mailing Address - Phone:919-321-2822
Mailing Address - Fax:
Practice Address - Street 1:100 MANNING DR
Practice Address - Street 2:C/O CLINICAL CARE MANAGEMENT
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-6117
Practice Address - Country:US
Practice Address - Phone:919-966-0230
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-30
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0052371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical