Provider Demographics
NPI:1710744156
Name:LOVATO, INEZ JOANN (LCSW)
Entity Type:Individual
Prefix:
First Name:INEZ
Middle Name:JOANN
Last Name:LOVATO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:INEZ
Other - Middle Name:
Other - Last Name:GURULE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1934
Mailing Address - Street 2:
Mailing Address - City:CLOVIS
Mailing Address - State:NM
Mailing Address - Zip Code:88102-1934
Mailing Address - Country:US
Mailing Address - Phone:575-218-9809
Mailing Address - Fax:
Practice Address - Street 1:2600 NORTHGLEN DR
Practice Address - Street 2:
Practice Address - City:CLOVIS
Practice Address - State:NM
Practice Address - Zip Code:88101-2935
Practice Address - Country:US
Practice Address - Phone:575-218-9809
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMC-090101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical