Provider Demographics
NPI:1205915063
Name:LOVELACE, SHARON MARION
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:MARION
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 HOLLY BERRY LN
Mailing Address - Street 2:
Mailing Address - City:LUGOFF
Mailing Address - State:SC
Mailing Address - Zip Code:29078-8874
Mailing Address - Country:US
Mailing Address - Phone:803-438-1937
Mailing Address - Fax:
Practice Address - Street 1:511 W MOULTRIE ST
Practice Address - Street 2:
Practice Address - City:WINNSBORO
Practice Address - State:SC
Practice Address - Zip Code:29180-1436
Practice Address - Country:US
Practice Address - Phone:803-712-1649
Practice Address - Fax:809-712-6960
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health