Provider Demographics
NPI:1912628389
Name:COVINGTON, DYAN (LPC)
Entity Type:Individual
Prefix:
First Name:DYAN
Middle Name:
Last Name:COVINGTON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7305 ABERDEEN AVE APT 3404
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-2517
Mailing Address - Country:US
Mailing Address - Phone:806-620-6338
Mailing Address - Fax:
Practice Address - Street 1:5717 66TH ST STE 123
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-1214
Practice Address - Country:US
Practice Address - Phone:806-620-6338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-06
Last Update Date:2022-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82902101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty