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Organization
COVENANT BEHAVIORAL HEALTH LLC
Active
Organization
COVENANT BEHAVIORAL HEALTH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CATHERINE NKEIRUKA BEN-AGU (PRESIDENT)
(571) 505-1775
Entity
Organization
Contact information
Practice address
5656 LIBERTY MANOR CIR, WOODBRIDGE, VA 22193-3279
(571) 505-1775
Mailing address
5656 LIBERTY MANOR CIR, WOODBRIDGE, VA 22193-3279
(571) 505-1775
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
NULL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
11/21/2022
Last updated
02/02/2023
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