Provider Demographics
NPI:1326205865
Name:LOVELL, ANITA K (MA)
Entity Type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:K
Last Name:LOVELL
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 S 70TH ST
Mailing Address - Street 2:SUITE 225
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68510-7905
Mailing Address - Country:US
Mailing Address - Phone:402-325-0117
Mailing Address - Fax:402-817-3681
Practice Address - Street 1:1001 S 70TH ST
Practice Address - Street 2:SUITE 225
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68510-7905
Practice Address - Country:US
Practice Address - Phone:402-325-0117
Practice Address - Fax:402-817-3681
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-21
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3986101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE3986OtherSTATE LICENSURE
NE10025871300Medicaid