Provider Demographics
NPI:1114093119
Name:LOVERTI, JASON (MSW, LCSW)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:
Last Name:LOVERTI
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8383 NE SANDY BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97220-4967
Mailing Address - Country:US
Mailing Address - Phone:503-253-0964
Mailing Address - Fax:
Practice Address - Street 1:8383 NE SANDY BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220-4967
Practice Address - Country:US
Practice Address - Phone:503-253-0964
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2017-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA205391041C0700X
ORL47561041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical