Provider Demographics
NPI:1093923260
Name:LOVETT, RAYMOND E (LCSW)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:E
Last Name:LOVETT
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5042 STATE RT 315
Mailing Address - Street 2:
Mailing Address - City:PAWLET
Mailing Address - State:VT
Mailing Address - Zip Code:05761-9507
Mailing Address - Country:US
Mailing Address - Phone:802-353-6590
Mailing Address - Fax:802-325-2608
Practice Address - Street 1:3057 ROUTE 30
Practice Address - Street 2:
Practice Address - City:DORSET
Practice Address - State:VT
Practice Address - Zip Code:05251-3710
Practice Address - Country:US
Practice Address - Phone:802-353-6590
Practice Address - Fax:802-325-2608
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-19
Last Update Date:2012-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT089.0000353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health