Provider Demographics
NPI:1306922570
Name:WESTGATE LOVETT, BONNIE LYN (LIMHP)
Entity type:Individual
Prefix:DR
First Name:BONNIE
Middle Name:LYN
Last Name:WESTGATE LOVETT
Suffix:
Gender:F
Credentials:LIMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 ORANGE BLOSSOM DR
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-6951
Mailing Address - Country:US
Mailing Address - Phone:402-603-0095
Mailing Address - Fax:
Practice Address - Street 1:856 ORANGE BLOSSOM DR
Practice Address - Street 2:
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-6951
Practice Address - Country:US
Practice Address - Phone:402-603-0095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-31
Last Update Date:2024-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXLP16545101Y00000X
LA7443101YP2500X
FLMH8970101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional