Provider Demographics
NPI:1386949527
Name:LOVELADY-SMITH, MICHELLE MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:MARIE
Last Name:LOVELADY-SMITH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1230
Mailing Address - Country:US
Mailing Address - Phone:812-423-7791
Mailing Address - Fax:812-436-4316
Practice Address - Street 1:415 MULBERRY ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47713
Practice Address - Country:US
Practice Address - Phone:812-423-7791
Practice Address - Fax:812-436-4316
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-19
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34006024A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical