Provider Demographics
NPI:1790187185
Name:LOVELL, MARCIE ALAYNE (MSW LCSW-C)
Entity Type:Individual
Prefix:
First Name:MARCIE
Middle Name:ALAYNE
Last Name:LOVELL
Suffix:
Gender:F
Credentials:MSW LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5570 STERRETT PL
Mailing Address - Street 2:206
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-2641
Mailing Address - Country:US
Mailing Address - Phone:410-884-6031
Mailing Address - Fax:410-884-6134
Practice Address - Street 1:5570 STERRETT PL
Practice Address - Street 2:206
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-2641
Practice Address - Country:US
Practice Address - Phone:410-884-6031
Practice Address - Fax:410-884-6134
Is Sole Proprietor?:No
Enumeration Date:2014-09-17
Last Update Date:2014-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD17667101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD17667OtherMARYLAND LICENSE NUMBER