Provider Demographics
NPI:1700601341
Name:COVERSTON, ROBERT LOWELL JR
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LOWELL
Last Name:COVERSTON
Suffix:JR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:BOBBY
Other - Middle Name:
Other - Last Name:COVERSTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2416 21ST AVE S STE 203
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-5312
Mailing Address - Country:US
Mailing Address - Phone:615-499-5453
Mailing Address - Fax:
Practice Address - Street 1:2416 21ST AVE S
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-5316
Practice Address - Country:US
Practice Address - Phone:615-499-5453
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-19
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health