Provider Demographics
NPI:1912067380
Name:LOVELL, PAT (LPC, LMSW ,AAC, LMFT)
Entity Type:Individual
Prefix:
First Name:PAT
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:LPC, LMSW ,AAC, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:409 S GRAHAM ST
Mailing Address - Street 2:
Mailing Address - City:STEPHENVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:76401-4425
Mailing Address - Country:US
Mailing Address - Phone:254-968-4020
Mailing Address - Fax:254-965-3734
Practice Address - Street 1:409 S GRAHAM ST
Practice Address - Street 2:
Practice Address - City:STEPHENVILLE
Practice Address - State:TX
Practice Address - Zip Code:76401-4425
Practice Address - Country:US
Practice Address - Phone:254-968-4020
Practice Address - Fax:254-965-3734
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2013-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1179-0800101YA0400X
TX10026101YP2500X
TX12335104100000X
TX001158042479106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX027824401Medicaid
TX010867992OtherTIN