Provider Demographics
NPI:1790495232
Name:BELOVED THERAPY LLC
Entity Type:Organization
Organization Name:BELOVED THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LOVICK
Authorized Official - Suffix:
Authorized Official - Credentials:MDIV, MA, LMFT
Authorized Official - Phone:608-616-5085
Mailing Address - Street 1:414 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:WI
Mailing Address - Zip Code:53523-9144
Mailing Address - Country:US
Mailing Address - Phone:608-616-5085
Mailing Address - Fax:
Practice Address - Street 1:414 W MAIN ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:WI
Practice Address - Zip Code:53523-9144
Practice Address - Country:US
Practice Address - Phone:608-616-5085
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-23
Last Update Date:2022-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty