Provider Demographics
NPI:1841982493
Name:LOVELL, ELIZABETH (NCSP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:NCSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:706 LULA CT
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-9005
Mailing Address - Country:US
Mailing Address - Phone:304-716-6334
Mailing Address - Fax:
Practice Address - Street 1:706 LULA CT
Practice Address - Street 2:
Practice Address - City:HURRICANE
Practice Address - State:WV
Practice Address - Zip Code:25526-9005
Practice Address - Country:US
Practice Address - Phone:304-716-6334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-23
Last Update Date:2023-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVN7T144200044103TS0200X
OHOH3312109103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool