Provider Demographics
NPI:1730843160
Name:KOVACH, DAVID BRIAN JR (LPC)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:BRIAN
Last Name:KOVACH
Suffix:JR
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E OGDEN AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-3776
Mailing Address - Country:US
Mailing Address - Phone:224-398-3191
Mailing Address - Fax:224-263-5537
Practice Address - Street 1:201 E OGDEN AVE STE 118
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-3776
Practice Address - Country:US
Practice Address - Phone:224-398-3191
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-21
Last Update Date:2022-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL178.017548101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health