Provider Demographics
NPI:1679205470
Name:COVIELLO, BRYAN DANIEL (RMHCI)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:DANIEL
Last Name:COVIELLO
Suffix:
Gender:M
Credentials:RMHCI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3275 W HILLSBORO BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:DEERFIELD BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33442-9410
Mailing Address - Country:US
Mailing Address - Phone:954-571-5102
Mailing Address - Fax:
Practice Address - Street 1:NEW DIRECTIONS FOR YOUNG ADULTS 3275 W HILLSBORO BLVD S
Practice Address - Street 2:
Practice Address - City:DEERFIELD BEACH
Practice Address - State:FL
Practice Address - Zip Code:33442-3344
Practice Address - Country:US
Practice Address - Phone:954-571-5102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-29
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH20418101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health