Provider Demographics
NPI:1508202516
Name:COVEY, NICCOLE (LLPC)
Entity Type:Individual
Prefix:MS
First Name:NICCOLE
Middle Name:
Last Name:COVEY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 CASS AVE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:MOUNT CLEMENS
Mailing Address - State:MI
Mailing Address - Zip Code:48043-2252
Mailing Address - Country:US
Mailing Address - Phone:586-260-4730
Mailing Address - Fax:
Practice Address - Street 1:117 CASS AVE
Practice Address - Street 2:SUITE 300
Practice Address - City:MOUNT CLEMENS
Practice Address - State:MI
Practice Address - Zip Code:48043-2252
Practice Address - Country:US
Practice Address - Phone:586-260-4730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401013378101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health