Provider Demographics
NPI:1124336912
Name:LOVELACE, JANA L (PSYD)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:L
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3109 UPPER RIVER RD STE B
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:AL
Mailing Address - Zip Code:35603-5509
Mailing Address - Country:US
Mailing Address - Phone:256-472-4600
Mailing Address - Fax:
Practice Address - Street 1:3109 UPPER RIVER RD STE B
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:AL
Practice Address - Zip Code:35603-5509
Practice Address - Country:US
Practice Address - Phone:256-472-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-15
Last Update Date:2024-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2961103TC0700X
AL1645103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical