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:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LAUREN
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:LOVELL
Authorized Official - Suffix:
Authorized Official - Credentials:BCBA
Authorized Official - Phone:239-850-3679
Mailing Address - Street 1:1225 SW 34TH TER
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33914-5147
Mailing Address - Country:US
Mailing Address - Phone:239-850-3679
Mailing Address - Fax:
Practice Address - Street 1:6150 DIAMOND CENTRE CT BLDG 200
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33912-4367
Practice Address - Country:US
Practice Address - Phone:239-850-3679
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-19
Last Update Date:2020-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health