Healthcare Provider Details

I. General information

NPI: 1104385863
Provider Name (Legal Business Name): LOVELYNE JOSEPH PMHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2019
Last Update Date: 10/23/2025
Certification Date: 10/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 ALTMORE AVE STE 200
ATLANTA GA
30342-2495
US

IV. Provider business mailing address

1200 ALTMORE AVE STE 200
ATLANTA GA
30342-2495
US

V. Phone/Fax

Practice location:
  • Phone: 678-426-2930
  • Fax: 404-256-2795
Mailing address:
  • Phone: 678-426-2930
  • Fax: 404-256-2795

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN9391204
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN-NP297387
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN297387
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: