Provider Demographics
NPI:1265509954
Name:LOVETT, GERALD DAVID (D MIN)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:DAVID
Last Name:LOVETT
Suffix:
Gender:M
Credentials:D MIN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 10944
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37939-0944
Mailing Address - Country:US
Mailing Address - Phone:865-584-9001
Mailing Address - Fax:865-584-3998
Practice Address - Street 1:5731 LYONS VIEW PIKE
Practice Address - Street 2:SUITE 202
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-6434
Practice Address - Country:US
Practice Address - Phone:865-584-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2009-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000000011101YP1600X
TN0000001195101YP2500X
NC3205101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional