Provider Demographics
NPI:1134478357
Name:COVENANT FAMILY SERVICES
Entity type:Organization
Organization Name:COVENANT FAMILY SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PROPRIETOR
Authorized Official - Prefix:MR
Authorized Official - First Name:MARCEL
Authorized Official - Middle Name:W
Authorized Official - Last Name:SLOWLY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:203-906-5161
Mailing Address - Street 1:550 NEW HAVEN AVE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06460-3618
Mailing Address - Country:US
Mailing Address - Phone:203-448-1848
Mailing Address - Fax:203-283-7714
Practice Address - Street 1:550 NEW HAVEN AVE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:CT
Practice Address - Zip Code:06460-3618
Practice Address - Country:US
Practice Address - Phone:203-446-1848
Practice Address - Fax:203-283-7714
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-04
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT00004798163WP0808X
CT0073731041C0700X
CT101YA0400X
261QR0405X, 363LF0000X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Multi-Specialty
No163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No261QR0405XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation, Substance Use DisorderGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty