Covenant 21St Century Ministries, Inc

Primary specialty

Mental Illness Community Based Residential Treatment FacilityTaxonomy code 320800000X

License

80714001 Issued in VA

Legal business name

COVENANT 21ST CENTURY MINISTRIES, INC

Practice address

260 Filbert St
Norfolk, VA 23505-4410

Phone

(757) 493-2912

Fax

(757) 493-2913

NPI assigned

Mar 11, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Portia Deneen Rawles, PSY D

Title

Clinical Director

Phone

(757) 493-2912

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Covenant Place Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1205193600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1239667200000",
    "number": "1508036054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5301 PROVIDENCE RD",
            "address_2": "SUITE 20",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234644128",
            "telephone_number": "757-493-2912",
            "fax_number": "757-493-2913"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 FILBERT ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235054410",
            "telephone_number": "757-493-2912",
            "fax_number": "757-493-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT 21ST CENTURY MINISTRIES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-11",
        "last_updated": "2009-04-14",
        "status": "A",
        "authorized_official_last_name": "RAWLES",
        "authorized_official_first_name": "PORTIA",
        "authorized_official_middle_name": "DENEEN",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "757-493-2912",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSY D"
    },
    "taxonomies": [
        {
            "code": "320800000X",
            "taxonomy_group": "",
            "desc": "Community Based Residential Treatment Facility, Mental Illness",
            "state": "VA",
            "license": "80714001",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1508036054",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Covenant Place",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Courtney Courson
• Derek Lamont Cousins, PA-C
• Teresa Cousins, CRNA
• Cova Care, PLLC
• Covel Family Services
• Covenant Connections Behavioral Health Services
• Covenant Connections LLC
• Hannah Covington, LPC
• Rebecca Catherine Macdonald Covington
• Kevin Joseph Coward, L.P.C.

• Mental Illness Community Based Residential Treatment Facility in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Mental Illness Community Based Residential Treatment Facility in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.