Provider Demographics
NPI:1427616598
Name:LOVELACE, NINA (MSW, LMSW)
Entity type:Individual
Prefix:
First Name:NINA
Middle Name:
Last Name:LOVELACE
Suffix:
Gender:F
Credentials:MSW, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BOOTH ST UNIT 255
Mailing Address - Street 2:
Mailing Address - City:GAITHERSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:20878-6591
Mailing Address - Country:US
Mailing Address - Phone:240-375-6530
Mailing Address - Fax:
Practice Address - Street 1:7003 PINEY BRANCH RD NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20012-2417
Practice Address - Country:US
Practice Address - Phone:240-375-6530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-03
Last Update Date:2019-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD21602104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NAOtherNA