Healthcare Provider Details

I. General information

NPI: 1588081301
Provider Name (Legal Business Name): LAUREN A. LOVELL INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/19/2014
Last Update Date: 08/29/2025
Certification Date: 01/27/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12438 BRANTLEY COMMONS COURT
FORT MYERS FL
33907-5683
US

IV. Provider business mailing address

11200 CALLAWAY GREENS DRIVE
FORT MYERS FL
33913-8139
US

V. Phone/Fax

Practice location:
  • Phone: 239-270-5921
  • Fax: 855-796-6622
Mailing address:
  • Phone: 239-270-5921
  • Fax: 855-796-6622

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number State

VIII. Authorized Official

Name: MS. LAUREN A LOVELL
Title or Position: OWNER/DIRECTOR
Credential: BCBA
Phone: 239-850-3679