Provider Demographics
NPI:1255602983
Name:COVEY LLC
Entity type:Organization
Organization Name:COVEY LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:COVEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:208-520-9649
Mailing Address - Street 1:730 E CLARK ST # 4571
Mailing Address - Street 2:
Mailing Address - City:POCATELLO
Mailing Address - State:ID
Mailing Address - Zip Code:83201-6238
Mailing Address - Country:US
Mailing Address - Phone:208-520-9649
Mailing Address - Fax:
Practice Address - Street 1:730 E CLARK ST # 4571
Practice Address - Street 2:
Practice Address - City:POCATELLO
Practice Address - State:ID
Practice Address - Zip Code:83201-6238
Practice Address - Country:US
Practice Address - Phone:208-520-9649
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-01-26
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty