THERESA M COVINGTON (NPI# 1952470635) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952470635 |
| Entity Type | Individual |
| Full Name | THERESA M COVINGTON |
| Credential | PH.D. |
| Practice Address |
2605 Brewerton Rd Mattydale NY 13211-1147 |
| Mailing Address |
Po Box 58 Baldwinsville NY 13027-0058 |
| Practice Telephone | 3159353037 |
| Practice Fax Number | 3152952614 |
| Mailing Telephone | 3159353037 |
| Mailing Fax Number | 3152952614 |
| Enumeration Date | 2006-11-07 |
| Last Update Date | 2014-01-28 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103G00000X | Clinical Neuropsychologist | CT002407 | CT | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
012316 | NY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| CT | LICENSE | CT002407 | 01 |
| Street Address |
2605 BREWERTON RD |
| City | MATTYDALE |
| State | NY |
| Zip Code | 13211-1147 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215044201 | Clinton Charles Conger | Chiropractor | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2006-08-24 |
| 1962055954 | Corey Smith | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2019-07-19 |
| 1306316484 | Samantha Marie Rawson | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2018-11-30 |
| 1053800128 | Kara Elisabeth Shostack | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2018-05-04 |
| 1447757950 | Tiffani Lynn Rombach | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2018-04-11 |
| 1114445970 | Kyle Mcauliffe | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2017-08-31 |
| 1821520891 | Elizabeth Daniel | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2017-03-29 |
| 1043604036 | Bethany Gratien | Community Health Worker | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2015-03-27 |
| 1821415738 | Kurt Mcardell | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2014-03-28 |
| 1821427873 | Emily Alfieri | Massage Therapist | 2605 Brewerton Rd, Mattydale, NY 13211-1147 | 2013-11-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154692259 | Elizabeth Mitchell | Massage Therapist | 2605 Brewerton Roadd Lin, A Touch Above, Mattydale, NY 13211 | 2012-01-20 |
| 1265616189 | James Laurence Devine | Pharmacist | 2616 Brewerton Rd, Mattydale, NY 13211 | 2007-12-27 |
| 1770605784 | John Palazzoli | Pharmacist | 2803 Brewerton Rd, Mattydale, NY 13211-1003 | 2007-04-03 |
| 1407283161 | Andrea Marie Rubin | Pharmacist | 2803 Brewerton Rd, Mattydale, NY 13211-1003 | 2013-09-26 |
| 1689007585 | Justin Christopher Acker | Pharmacist | 2803 Brewerton Rd, Mattydale, NY 13211-1003 | 2013-08-14 |
| 1538190681 | K Mart Corp | Pharmacy | 2803 Brewerton Rd, Mattydale, NY 13211-1003 | 2006-07-06 |
| 1538268891 | Eckerd Corporation | Durable Medical Equipment & Medical Supplies | 2616 Brewerton Road, Mattydale, NY 13211-1202 | 2006-09-22 |
| 1063936185 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2616 Brewerton Rd, Mattydale, NY 13211-1202 | 2017-07-31 |
| 1154506723 | Shelley Jean Gallo | Pharmacist | 2616 Brewerton Rd, Mattydale, NY 13211-1202 | 2008-01-02 |
| 1477796159 | Vincent J. Scalisi | Chiropractor | 126 Campbell Rd # 1, Mattydale, NY 13211-1204 | 2009-04-11 |
| Find all providers in zip 13211 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396346060 | Alexandra Hittman | Psychologist | 26 Palisade St, Dobbs Ferry, NY 10522-2107 | 2020-11-07 |
| 1184225849 | Linda L Street | Psychologist | 165 Saint Regis Dr, Massapequa Park, NY 11762-3454 | 2020-11-07 |
| 1063012318 | Inga Korsgaard | Psychologist | 233 Broadway Rm 850, New York, NY 10279-0800 | 2020-10-27 |
| 1194324657 | Elizabeth Brunoski | Psychologist | 50 W 67th St Ste 5h, New York, NY 10023-6227 | 2020-10-25 |
| 1760081830 | Meagan Ryan | Psychologist | 1 3rd Ave Apt 516, Mineola, NY 11501-4340 | 2020-10-20 |
| 1912505587 | Elspeth Hayden Kelly | Psychologist | 519 8th Ave Fl 8, New York, NY 10018-6506 | 2020-10-15 |
| 1700484623 | Rena Lee Miller | Psychologist | 252 N 6th St Apt 17, Brooklyn, NY 11211-3367 | 2020-10-13 |
| 1558968842 | Ethan Eisen | Psychologist | 107 Lakeside Dr E, Lawrence, NY 11559-1718 | 2020-10-08 |
| 1790382398 | Katelynn Marie Faulkner | Psychologist | 1 Old Plank Rd # 1d, Clinton, NY 13323-1802 | 2020-10-06 |
| 1811594039 | Pinchus Feintuch | Psychologist | 1580 E 18th St Ste 101, Brooklyn, NY 11230-7261 | 2020-10-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on THERESA M COVINGTON.
| 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.