Provider Demographics
NPI:1609105030
Name:COVINGTON, KENDRA (BA, MS, LMFT)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:BA, MS, LMFT
Other - Prefix:
Other - First Name:KENDRA
Other - Middle Name:
Other - Last Name:WOLVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 322
Mailing Address - Street 2:
Mailing Address - City:SLATER
Mailing Address - State:IA
Mailing Address - Zip Code:50244-0322
Mailing Address - Country:US
Mailing Address - Phone:402-419-9357
Mailing Address - Fax:
Practice Address - Street 1:3600 30TH ST
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50310-5753
Practice Address - Country:US
Practice Address - Phone:402-419-9357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-14
Last Update Date:2023-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE9039101YM0800X
NE32106H00000X
IA00367106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025836700Medicaid