Provider Demographics
NPI:1538588645
Name:PRATT - LOVERCHECK PRACTICE
Entity type:Organization
Organization Name:PRATT - LOVERCHECK PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:BRENDA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:LOVERCHECK
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:307-534-5582
Mailing Address - Street 1:1086 B US HWY 85
Mailing Address - Street 2:
Mailing Address - City:LAGRANGE
Mailing Address - State:WY
Mailing Address - Zip Code:82221
Mailing Address - Country:US
Mailing Address - Phone:307-534-5582
Mailing Address - Fax:
Practice Address - Street 1:231 CAMINO DEL REY
Practice Address - Street 2:
Practice Address - City:TORRINGTON
Practice Address - State:WY
Practice Address - Zip Code:82240
Practice Address - Country:US
Practice Address - Phone:307-534-5582
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WYLCSW-5141041C0700X
WYWY 386103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty