Provider Demographics
NPI:1619729647
Name:KOVEN, JULIE (PHD)
Entity Type:Individual
Prefix:DR
First Name:JULIE
Middle Name:
Last Name:KOVEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:167 MADISON AVE RM 205
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-5403
Mailing Address - Country:US
Mailing Address - Phone:929-489-1160
Mailing Address - Fax:
Practice Address - Street 1:167 MADISON AVE RM 205
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-5403
Practice Address - Country:US
Practice Address - Phone:929-489-1160
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025939103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling