Provider Demographics
NPI:1356630560
Name:LOVETT, LESLIE ANN (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:LESLIE
Middle Name:ANN
Last Name:LOVETT
Suffix:
Gender:F
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 1:1103 LYRA LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76013-8327
Mailing Address - Country:US
Mailing Address - Phone:817-456-0123
Mailing Address - Fax:
Practice Address - Street 1:1103 LYRA LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76013-8327
Practice Address - Country:US
Practice Address - Phone:817-456-0123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2011-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX405571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical