Provider Demographics
NPI:1407036478
Name:DOFAT AVENT, LOVANNIA RENEE (LCSWC)
Entity Type:Individual
Prefix:MS
First Name:LOVANNIA
Middle Name:RENEE
Last Name:DOFAT AVENT
Suffix:
Gender:F
Credentials:LCSWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10705 VISTA LINDA DRIVE
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721
Mailing Address - Country:US
Mailing Address - Phone:240-244-0249
Mailing Address - Fax:
Practice Address - Street 1:4640 FORBES BLVD STE 120W
Practice Address - Street 2:
Practice Address - City:LANHAM
Practice Address - State:MD
Practice Address - Zip Code:20706-6320
Practice Address - Country:US
Practice Address - Phone:240-245-0249
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-07
Last Update Date:2020-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3000766104100000X
MD10860104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker