Provider Demographics
NPI:1700493038
Name:LOVETT, NAKEYA
Entity Type:Individual
Prefix:MR
First Name:NAKEYA
Middle Name:
Last Name:LOVETT
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 1:4355 HIGH BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:FL
Mailing Address - Zip Code:32351-6128
Mailing Address - Country:US
Mailing Address - Phone:850-290-7296
Mailing Address - Fax:
Practice Address - Street 1:4355 HIGH BRIDGE RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:FL
Practice Address - Zip Code:32351-6128
Practice Address - Country:US
Practice Address - Phone:850-290-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-30
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLL130636753010OtherDRIVERS LICENSE