Provider Demographics
NPI:1316984115
Name:LOVELACE, ELAINE A (PHD)
Entity type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:A
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:PHD
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 20730
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:PA
Mailing Address - Zip Code:17402-0183
Mailing Address - Country:US
Mailing Address - Phone:717-751-6851
Mailing Address - Fax:717-751-6852
Practice Address - Street 1:3206 E MARKET ST
Practice Address - Street 2:
Practice Address - City:YORK
Practice Address - State:PA
Practice Address - Zip Code:17402-2506
Practice Address - Country:US
Practice Address - Phone:717-751-6851
Practice Address - Fax:717-751-6852
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS008519L103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA028269Medicare ID - Type Unspecified