COVENANT RECOVERY CENTER LLC (NPI# 1366959561) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366959561 |
| Entity Type | Organization |
| Organization Name | COVENANT RECOVERY CENTER LLC |
| Other Organization Name | COVENANT RECOVERY CENTER |
| Practice Address |
3007 Memorial Pkwy Sw Ste C Huntsville AL 35801-5394 |
| Practice Telephone | 2568822003 |
| Practice Fax Number | 2567054630 |
| Mailing Telephone | 2568822003 |
| Mailing Fax Number | 2567054630 |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2018-01-09 |
| Authorized Official Name | DR. KENNETH DEAN WILLIS (SOLE MEMBER) |
| Authorized Official Telephone | 2568822003 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers |
| Other Name | Type Code |
|---|---|
| Covenant Recovery Center | Doing Business As Name - Organization |
| Street Address |
3007 MEMORIAL PKWY SW STE C |
| City | HUNTSVILLE |
| State | AL |
| Zip Code | 35801-5394 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003422742 | Elena Mihaela Kruse | Nurse Practitioner | 415 Echurch St, Nw Suite 4, Huntsville, AL 35801 | 2020-09-18 |
| 1225657661 | Ashley Danielle Ford | Student in an Organized Health Care Education/Training Program | 301 Governors Drive Se, Huntsville, AL 35801 | 2020-04-15 |
| 1407417702 | Sasha J White | Specialist | 410 Governors Dr. Sw, Huntsville, AL 35801 | 2019-06-26 |
| 1003472978 | Gina Marie Delgado | Nurse Practitioner | Huntsville Hospital Cvicu, 101 Sivley Rd., Huntsville, AL 35801 | 2019-05-15 |
| 1366909863 | Lisa Starkey Suggs | Nurse Practitioner | 3500 Memorial Parkway S.w., Huntsville, AL 35801 | 2019-02-21 |
| 1902373277 | Kelly S Fisher LLC | Counselor | 300 Clinton Avenue, Suite 22 A, Huntsville, AL 35801 | 2018-10-25 |
| 1073097911 | Brittani B Hamrick | Psychologist | 203 Eastside Sq Ste C9, Huntsville, AL 35801 | 2018-09-17 |
| 1548748312 | Jane O. Orton, Licsw, LLC | Social Worker | 120 Holmes Ave Ne, Huntsville, AL 35801 | 2018-08-02 |
| 1184100661 | Regroup Psychological Services | Psychologist | 2006 Franklin St. Se, Suite 110, Huntsville, AL 35801 | 2018-07-17 |
| 1366968398 | Bennett Brent Smith | Physician Assistant | 825 Adams St. Se, Huntsville, AL 35801 | 2017-08-22 |
| Find all providers in zip 35801 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770129892 | Lateisha Elliott | Counselor | 509 Madison St Se, Huntsville, AL 35801-4206 | 2019-11-24 |
| 1912362971 | Martez R. Rogers | Counselor | 1208 Mcclung Ave Se, Huntsville, AL 35801-2507 | 2015-12-17 |
| 1194102509 | Corlotta Zachary | Counselor | 98 Willowbend St, Huntsville, TX 77320-3031 | 2015-05-05 |
| 1639560683 | Charlotte Johnson | Counselor | 2049 Max Luther Dr Nw, Huntsville, AL 35810-3801 | 2015-02-12 |
| 1578960530 | Miller Professional Counseling, P.C. | Counselor | 415e Church St Nw, Suite 11, Huntsville, AL 35801-5578 | 2014-11-19 |
| 1609294388 | Deborah O'donnell | Counselor | 1325 Windsor St Ste B, Huntsville, TX 77340-5702 | 2014-03-31 |
| 1083930556 | Robert Daniel Robinson | Counselor | 3010 Montgomery Rd, Huntsville, TX 77340-6022 | 2010-04-09 |
| 1619011038 | Byrom Odell Goodwin Sr. | Counselor | 333 Franklin St Se Ste 100, Huntsville, AL 35801-4264 | 2007-02-18 |
| 1073666244 | Center for Marriage and Family Therapy, LLC | Counselor | 116 Lily Flagg Road, Suite D, Huntsville, AL 35802-3066 | 2007-01-19 |
| 1265916431 | Reshonda Griffin | Counselor | 500 Markaview Rd Nw, Huntsville, AL 35805-3652 | 2018-09-24 |
| Find all providers in HUNTSVILLE | ||||
| City | HUNTSVILLE |
| Zip Code | 35801 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.