Provider Demographics
NPI:1588062228
Name:TAYLOR, LOVELY D (LMHP)
Entity type:Individual
Prefix:
First Name:LOVELY
Middle Name:D
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4611 S 96TH ST STE 233
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68127-1243
Mailing Address - Country:US
Mailing Address - Phone:402-507-0987
Mailing Address - Fax:833-517-5440
Practice Address - Street 1:4611 S 96TH ST STE 233
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68127-1243
Practice Address - Country:US
Practice Address - Phone:402-507-0987
Practice Address - Fax:833-517-5440
Is Sole Proprietor?:No
Enumeration Date:2014-12-11
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE4954101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health