Provider Demographics
NPI:1376103036
Name:COVILLE COUNSELING AND ASSESSMENT
Entity type:Organization
Organization Name:COVILLE COUNSELING AND ASSESSMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOLOGIST
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:COVILLE
Authorized Official - Suffix:
Authorized Official - Credentials:MA LLP
Authorized Official - Phone:616-893-0983
Mailing Address - Street 1:983 SPAULDING AVE SE
Mailing Address - Street 2:
Mailing Address - City:ADA
Mailing Address - State:MI
Mailing Address - Zip Code:49301-3701
Mailing Address - Country:US
Mailing Address - Phone:616-893-0983
Mailing Address - Fax:616-930-4669
Practice Address - Street 1:983 SPAULDING AVE SE
Practice Address - Street 2:
Practice Address - City:ADA
Practice Address - State:MI
Practice Address - Zip Code:49301-3701
Practice Address - Country:US
Practice Address - Phone:616-893-0983
Practice Address - Fax:616-930-4669
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-15
Last Update Date:2019-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologistGroup - Single Specialty