Provider Demographics
NPI:1518259761
Name:LOVELACE, SHANEIKA CORANADA (LCPC)
Entity Type:Individual
Prefix:
First Name:SHANEIKA
Middle Name:CORANADA
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 ARROWOOD CT
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:MD
Mailing Address - Zip Code:21237-3868
Mailing Address - Country:US
Mailing Address - Phone:443-418-8707
Mailing Address - Fax:443-442-1569
Practice Address - Street 1:6918 RIDGE RD
Practice Address - Street 2:
Practice Address - City:ROSEDALE
Practice Address - State:MD
Practice Address - Zip Code:21237-3854
Practice Address - Country:US
Practice Address - Phone:443-442-1568
Practice Address - Fax:443-442-1569
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-06
Last Update Date:2011-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC3595101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional