Provider Demographics
NPI:1750940482
Name:LOVE, JAMIE ERIN (CADC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:ERIN
Last Name:LOVE
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9821 ELK LAKE TRL
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:MI
Mailing Address - Zip Code:49690-8514
Mailing Address - Country:US
Mailing Address - Phone:231-459-8350
Mailing Address - Fax:
Practice Address - Street 1:2594 SPRINGVALE RD
Practice Address - Street 2:
Practice Address - City:BOYNE FALLS
Practice Address - State:MI
Practice Address - Zip Code:49713-9684
Practice Address - Country:US
Practice Address - Phone:231-535-2822
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-06
Last Update Date:2019-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)