Provider Demographics
NPI:1821772351
Name:KOVACH, BRIEANNE (LLMSW)
Entity Type:Individual
Prefix:
First Name:BRIEANNE
Middle Name:
Last Name:KOVACH
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT PLEASANT
Mailing Address - State:MI
Mailing Address - Zip Code:48858-2303
Mailing Address - Country:US
Mailing Address - Phone:989-824-2374
Mailing Address - Fax:989-546-8550
Practice Address - Street 1:207 N FRANKLIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT PLEASANT
Practice Address - State:MI
Practice Address - Zip Code:48858-2303
Practice Address - Country:US
Practice Address - Phone:989-824-2374
Practice Address - Fax:989-546-8550
Is Sole Proprietor?:No
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68511167681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical