Provider Demographics
NPI:1356915045
Name:LOVELESS, ERIC JAMES
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:JAMES
Last Name:LOVELESS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2320 CHESTNUT DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ELM
Mailing Address - State:TX
Mailing Address - Zip Code:75068-5705
Mailing Address - Country:US
Mailing Address - Phone:903-517-5802
Mailing Address - Fax:
Practice Address - Street 1:805 E 1ST ST
Practice Address - Street 2:
Practice Address - City:PROSPER
Practice Address - State:TX
Practice Address - Zip Code:75078-2919
Practice Address - Country:US
Practice Address - Phone:469-481-6965
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-17
Last Update Date:2021-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX82249101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty