Provider Demographics
NPI:1326383761
Name:LOVERCHECK, BRENDA ANN (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:BRENDA
Middle Name:ANN
Last Name:LOVERCHECK
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1086 US HIGHWAY 85 UNIT B
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:WY
Mailing Address - Zip Code:82221-8451
Mailing Address - Country:US
Mailing Address - Phone:307-834-2328
Mailing Address - Fax:
Practice Address - Street 1:1086 US HIGHWAY 85 UNIT B
Practice Address - Street 2:
Practice Address - City:LAGRANGE
Practice Address - State:WY
Practice Address - Zip Code:82221-8451
Practice Address - Country:US
Practice Address - Phone:307-534-5582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-11
Last Update Date:2012-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-5141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical