Provider Demographics
NPI:1649532482
Name:COVINGTON, ANGELO MAURICE (MSW)
Entity type:Individual
Prefix:
First Name:ANGELO
Middle Name:MAURICE
Last Name:COVINGTON
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1184 LEMPSTER DR NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-4524
Mailing Address - Country:US
Mailing Address - Phone:704-292-0216
Mailing Address - Fax:
Practice Address - Street 1:1184 LEMPSTER DR NW
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-4524
Practice Address - Country:US
Practice Address - Phone:704-292-0216
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-07
Last Update Date:2022-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0086191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical