Provider Demographics
NPI:1588081301
Name:LAUREN A. LOVELL INC.
Entity type:Organization
Organization Name:LAUREN A. LOVELL INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/ BCBA/ PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:A
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:239-270-5921
Mailing Address - Street 1:11200 CALLAWAY GREENS DRIVE
Mailing Address - Street 2:
Mailing Address - City:FORT MYERS
Mailing Address - State:FL
Mailing Address - Zip Code:33913-8139
Mailing Address - Country:US
Mailing Address - Phone:239-270-5921
Mailing Address - Fax:855-796-6622
Practice Address - Street 1:12438 BRANTLEY COMMONS COURT
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-5683
Practice Address - Country:US
Practice Address - Phone:239-270-5921
Practice Address - Fax:855-796-6622
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL017630400Medicaid