Individual
ALYCIA COVELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LGSW
Contact information
Practice address
2415 WILLOUGHBY BEACH RD, EDGEWOOD, MD 21040
(410) 612-2071
Mailing address
2415 WILLOUGHBY BEACH RD, EDGEWOOD, MD 21040-3414
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
23892
MD
1041S0200X
School Social Worker
Primary
23892
MD
Other
Enumeration date
06/29/2018
Last updated
11/01/2019
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