Provider Demographics
NPI:1437420312
Name:LOVELAND, CHRISTA ANN (LCSW)
Entity Type:Individual
Prefix:
First Name:CHRISTA
Middle Name:ANN
Last Name:LOVELAND
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:PO BOX 1813
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-0545
Mailing Address - Country:US
Mailing Address - Phone:503-922-5950
Mailing Address - Fax:
Practice Address - Street 1:510 NE ROBERTS AVE STE 350
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7486
Practice Address - Country:US
Practice Address - Phone:503-512-8526
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-24
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)