Provider Demographics
NPI:1821842014
Name:LOVELL, AMBER (LCMHCA)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:LCMHCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3465 BERKLEY AVE
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80305-3435
Mailing Address - Country:US
Mailing Address - Phone:310-849-5147
Mailing Address - Fax:
Practice Address - Street 1:150 PRESTON EXECUTIVE DR STE 201
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27513-8485
Practice Address - Country:US
Practice Address - Phone:984-201-0494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-15
Last Update Date:2024-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA19552101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health