Provider Demographics
NPI:1417382151
Name:LOVELL, ROBYN KELLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:KELLEY
Last Name:LOVELL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:531 COLLIERS BEND RD
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:TN
Mailing Address - Zip Code:37036-5700
Mailing Address - Country:US
Mailing Address - Phone:615-516-3420
Mailing Address - Fax:
Practice Address - Street 1:531 COLLIERS BEND RD
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:TN
Practice Address - Zip Code:37036-5700
Practice Address - Country:US
Practice Address - Phone:615-516-3420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-12
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX27784104100000X
TN62881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker