Provider Demographics
NPI:1821481060
Name:LOVELL, LAWRENCE (LMHC)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:LOVELL
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1657 NOSTRAND AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-5579
Mailing Address - Country:US
Mailing Address - Phone:646-258-4394
Mailing Address - Fax:
Practice Address - Street 1:1000 DEAN ST
Practice Address - Street 2:STE 347
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11238-3381
Practice Address - Country:US
Practice Address - Phone:646-258-4394
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-12
Last Update Date:2017-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007159101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health