Provider Demographics
NPI:1043091085
Name:LOVELACE, SHAKIRA ZAKIA (LSW)
Entity Type:Individual
Prefix:MS
First Name:SHAKIRA
Middle Name:ZAKIA
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:627 TILTON RD STE 561
Mailing Address - Street 2:
Mailing Address - City:NORTHFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:08225-1219
Mailing Address - Country:US
Mailing Address - Phone:609-667-7819
Mailing Address - Fax:609-534-9188
Practice Address - Street 1:627 TILTON RD STE 561
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08225-1219
Practice Address - Country:US
Practice Address - Phone:609-667-7819
Practice Address - Fax:609-534-9188
Is Sole Proprietor?:No
Enumeration Date:2023-10-06
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL06274900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health