Provider Demographics
NPI:1841954419
Name:COVENANT COUNSELING & CONSULTING, LLC
Entity type:Organization
Organization Name:COVENANT COUNSELING & CONSULTING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:DENISE
Authorized Official - Middle Name:DIANNE
Authorized Official - Last Name:COOPER
Authorized Official - Suffix:
Authorized Official - Credentials:LSATP, CRC, MAC, CSA
Authorized Official - Phone:804-836-9729
Mailing Address - Street 1:5112 BURTWOOD LN
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23224-6059
Mailing Address - Country:US
Mailing Address - Phone:804-836-9729
Mailing Address - Fax:
Practice Address - Street 1:2211 DICKENS RD STE 250
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23230-2022
Practice Address - Country:US
Practice Address - Phone:804-836-9729
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-28
Last Update Date:2021-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty