Covington Place: Therapy & Counseling | |
1207 S Fir Ave Collins MS 39428-3809 | |
(601) 698-0263 | |
Not Available |
Full Name | Covington Place: Therapy & Counseling |
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Speciality | Clinic/Center |
Location | 1207 S Fir Ave, Collins, Mississippi |
Authorized Official Name and Position | Anissa L Evans (CREDENTIALING DIRECTOR) |
Authorized Official Contact | 6016980328 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Covington Place: Therapy & Counseling Po Box 2499 Collins MS 39428-2499 Ph: (601) 765-2746 | Covington Place: Therapy & Counseling 1207 S Fir Ave Collins MS 39428-3809 Ph: (601) 698-0263 |
NPI Number | 1831895911 |
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Provider Enumeration Date | 02/01/2023 |
Last Update Date | 04/12/2023 |
Certification Date | 04/12/2023 |
Medicare PECOS PAC ID | 4183517253 |
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Medicare Enrollment ID | O20230315002492 |
Identifier | Type | State | Issuer |
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1831895911 | NPI | - | NPPES |
Provider Name | Jennifer G Trihoulis |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1699891705 PECOS PAC ID: 9335248426 Enrollment ID: I20070702000276 |
Provider Name | Kenneth R Daughtrey |
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Provider Type | Practitioner - Psychiatry |
Provider Identifiers | NPI Number: 1902814361 PECOS PAC ID: 1153552963 Enrollment ID: I20140320000254 |
Provider Name | Charlie Jo Crafton |
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Provider Type | Practitioner - Nurse Practitioner |
Provider Identifiers | NPI Number: 1437872041 PECOS PAC ID: 6204293756 Enrollment ID: I20230529000235 |
Provider Name | Kimberly Bennett |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1710681614 PECOS PAC ID: 8325494354 Enrollment ID: I20231027001635 |
Covington County Hospital Mental Health Clinic Medicare: Medicare Enrolled Practice Location: 701 S Holly Ave, Collins, MS 39428 Phone: 601-765-6711 Fax: 601-698-0180 |