Provider Demographics
NPI:1669519641
Name:KOVACS, EULA BATES (LCSW MAC)
Entity type:Individual
Prefix:MS
First Name:EULA
Middle Name:BATES
Last Name:KOVACS
Suffix:
Gender:F
Credentials:LCSW MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 BLANDING BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32207
Mailing Address - Country:US
Mailing Address - Phone:904-399-0324
Mailing Address - Fax:904-399-0420
Practice Address - Street 1:4036 BLANDING BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32207
Practice Address - Country:US
Practice Address - Phone:904-399-0324
Practice Address - Fax:904-399-0420
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CERTIFICATE#04668103TA0400X
FLSW2374103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
K1420Medicare ID - Type UnspecifiedGROUP