Provider Demographics
NPI:1962813766
Name:LOVELL, SAMANTHA (LPC)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:LOVELL
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 OAK ST STE 3
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:AR
Mailing Address - Zip Code:72032-5679
Mailing Address - Country:US
Mailing Address - Phone:501-291-3091
Mailing Address - Fax:501-336-4037
Practice Address - Street 1:317 OAK ST STE 3
Practice Address - Street 2:
Practice Address - City:CONWAY
Practice Address - State:AR
Practice Address - Zip Code:72032-5679
Practice Address - Country:US
Practice Address - Phone:501-291-3091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-14
Last Update Date:2020-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARP1807083101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty