Provider Demographics
NPI:1861843641
Name:LOVICK, CLIFF I
Entity Type:Individual
Prefix:
First Name:CLIFF
Middle Name:
Last Name:LOVICK
Suffix:I
Gender:M
Credentials:
Other - Prefix:
Other - First Name:CLIFF
Other - Middle Name:
Other - Last Name:LOVICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1522 1ST ST # 106
Mailing Address - Street 2:
Mailing Address - City:CORONADO
Mailing Address - State:CA
Mailing Address - Zip Code:92118-1546
Mailing Address - Country:US
Mailing Address - Phone:619-213-6484
Mailing Address - Fax:
Practice Address - Street 1:1522 FRIST ST. APT M 106
Practice Address - Street 2:
Practice Address - City:CORONADA
Practice Address - State:CA
Practice Address - Zip Code:92118
Practice Address - Country:US
Practice Address - Phone:619-213-6484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)