Provider Demographics
NPI:1760535710
Name:COVEY, NICKI ANN (MS, NCC, LPC)
Entity Type:Individual
Prefix:MS
First Name:NICKI
Middle Name:ANN
Last Name:COVEY
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:MS
Other - First Name:NICKI
Other - Middle Name:ANN
Other - Last Name:CONTENTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, NCC, LPC
Mailing Address - Street 1:44 DARBYS CROSSING DR STE 202
Mailing Address - Street 2:
Mailing Address - City:HIRAM
Mailing Address - State:GA
Mailing Address - Zip Code:30141-6008
Mailing Address - Country:US
Mailing Address - Phone:678-896-8959
Mailing Address - Fax:678-550-1155
Practice Address - Street 1:44 DARBYS CROSSING DR STE 202
Practice Address - Street 2:
Practice Address - City:HIRAM
Practice Address - State:GA
Practice Address - Zip Code:30141-6008
Practice Address - Country:US
Practice Address - Phone:678-896-8959
Practice Address - Fax:678-550-1155
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-20
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC006475101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003176177AMedicaid