Healthcare Provider Details

I. General information

NPI: 1629599501
Provider Name (Legal Business Name): ANNA RAE LOVELACE LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2017
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6201 N GLENWOOD AVE APT 1
CHICAGO IL
60660-1882
US

IV. Provider business mailing address

6201 N GLENWOOD AVE APT 1
CHICAGO IL
60660-1882
US

V. Phone/Fax

Practice location:
  • Phone: 954-200-9671
  • Fax:
Mailing address:
  • Phone: 954-200-9671
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: