Provider Demographics
NPI:1851757140
Name:LOVELADY WELLS, TIFFANY TRELETTE (DPC, LPC, NCC, NCSC)
Entity Type:Individual
Prefix:DR
First Name:TIFFANY
Middle Name:TRELETTE
Last Name:LOVELADY WELLS
Suffix:
Gender:F
Credentials:DPC, LPC, NCC, NCSC
Other - Prefix:
Other - First Name:TIFFANY
Other - Middle Name:LOVELADY
Other - Last Name:HARRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:217 WESTFIELD RD
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157-9753
Mailing Address - Country:US
Mailing Address - Phone:769-234-4153
Mailing Address - Fax:769-207-7305
Practice Address - Street 1:2149 HIGHWAY 471
Practice Address - Street 2:
Practice Address - City:BRANDON
Practice Address - State:MS
Practice Address - Zip Code:39047-8748
Practice Address - Country:US
Practice Address - Phone:769-208-4992
Practice Address - Fax:769-207-7305
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-03
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS2039101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health