Provider Demographics
NPI:1124767173
Name:LOVELAND, HEATHER M (LADAC)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:M
Last Name:LOVELAND
Suffix:
Gender:F
Credentials:LADAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 HAVEN ST
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37075-3622
Mailing Address - Country:US
Mailing Address - Phone:615-804-7933
Mailing Address - Fax:888-789-2651
Practice Address - Street 1:115 HAVEN ST
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:TN
Practice Address - Zip Code:37075-3622
Practice Address - Country:US
Practice Address - Phone:615-804-7933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-28
Last Update Date:2023-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDC0000001511101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)