Basic Information
| Provider Information | |||||||||
| NPI: | 1992349005 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | MCCOVEY | ||||||||
| FirstName: | LELANETTE | ||||||||
| MiddleName: | OBEDI | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1090 E CYPRESS AVE STE B | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960021163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302232332 | ||||||||
| FaxNumber: | 5302234721 | ||||||||
| Practice Location | |||||||||
| Address1: | 1090 E CYPRESS AVE STE B | ||||||||
| Address2: | |||||||||
| City: | REDDING | ||||||||
| State: | CA | ||||||||
| PostalCode: | 960021163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5302232332 | ||||||||
| FaxNumber: | 5302234721 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/31/2019 | ||||||||
| LastUpdateDate: | 10/31/2019 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.