Provider Demographics
NPI:1306969589
Name:LOVING, JAMES LEE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:LEE
Last Name:LOVING
Suffix:
Gender:M
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:PO BOX 525
Mailing Address - Street 2:
Mailing Address - City:MEDIA
Mailing Address - State:PA
Mailing Address - Zip Code:19063-0525
Mailing Address - Country:US
Mailing Address - Phone:215-939-7393
Mailing Address - Fax:610-566-3497
Practice Address - Street 1:525 S 4TH ST
Practice Address - Street 2:SUITE 471
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19147-1570
Practice Address - Country:US
Practice Address - Phone:215-939-7393
Practice Address - Fax:610-566-3497
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2012-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS009070L103TC0700X
PAPS-009070-L103TF0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic