Covenant Behavioral Health LLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

COVENANT BEHAVIORAL HEALTH LLC

Practice address

5656 Liberty Manor Cir
Woodbridge, VA 22193-3279

Phone

(571) 505-1775

NPI assigned

Nov 21, 2022

Last updated

Feb 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Catherine Nkeiruka Ben-AguNPI 1801402508

Title

President

Phone

(571) 505-1775

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Catherine Nkeiruka Ben-Agu

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbridge, VA
  • NPI 1801402508

  Single Specialty

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675296000000",
    "number": "1790494573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5656 LIBERTY MANOR CIR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221933279",
            "telephone_number": "571-505-1775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5656 LIBERTY MANOR CIR",
            "city": "WOODBRIDGE",
            "state": "VA",
            "postal_code": "221933279",
            "telephone_number": "571-505-1775"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COVENANT BEHAVIORAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-21",
        "last_updated": "2023-02-02",
        "certification_date": "2023-02-02",
        "status": "A",
        "authorized_official_last_name": "BEN-AGU",
        "authorized_official_first_name": "CATHERINE",
        "authorized_official_middle_name": "NKEIRUKA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "571-505-1775"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Care@covenantbvh.com",
            "affiliation": "N",
            "address_1": "5656 Liberty Manor Cir",
            "city": "Woodbridge",
            "state": "VA",
            "country_code": "US",
            "postal_code": "221933279",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Woodbridge, VA
• Providers in Woodbridge, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.