Provider Demographics
NPI:1184255879
Name:COVEY, KARSON RAE (LMSW)
Entity type:Individual
Prefix:MRS
First Name:KARSON
Middle Name:RAE
Last Name:COVEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MRS
Other - First Name:KARSON
Other - Middle Name:RAE
Other - Last Name:VISSCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LLMSW
Mailing Address - Street 1:920 DIANA ST
Mailing Address - Street 2:
Mailing Address - City:LUDINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:49431-1987
Mailing Address - Country:US
Mailing Address - Phone:231-845-6294
Mailing Address - Fax:
Practice Address - Street 1:920 DIANA ST
Practice Address - Street 2:
Practice Address - City:LUDINGTON
Practice Address - State:MI
Practice Address - Zip Code:49431-1987
Practice Address - Country:US
Practice Address - Phone:231-845-6294
Practice Address - Fax:231-845-7095
Is Sole Proprietor?:No
Enumeration Date:2020-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68011167681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical