Provider Demographics
NPI:1831344985
Name:LOVITCH, JESSICA N (LMSW)
Entity type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:N
Last Name:LOVITCH
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 OLD ROUTE 17K
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:NY
Mailing Address - Zip Code:12549-1931
Mailing Address - Country:US
Mailing Address - Phone:845-548-5001
Mailing Address - Fax:845-457-1449
Practice Address - Street 1:18 OLD ROUTE 17K
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:NY
Practice Address - Zip Code:12549-1931
Practice Address - Country:US
Practice Address - Phone:845-548-5001
Practice Address - Fax:845-457-1449
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-17
Last Update Date:2008-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY064571-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker