Provider Demographics
NPI:1689364333
Name:COVINGTON, EIRENE ANJA (MA)
Entity Type:Individual
Prefix:
First Name:EIRENE
Middle Name:ANJA
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:STEPHANIE
Other - Middle Name:ALEXIS
Other - Last Name:GRANT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 BROOKSIDE COURT ANX
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4503
Mailing Address - Country:US
Mailing Address - Phone:615-576-0818
Mailing Address - Fax:
Practice Address - Street 1:2505 21ST AVE S STE 440
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-5652
Practice Address - Country:US
Practice Address - Phone:615-576-0818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional