Healthcare Provider Details

I. General information

NPI: 1972312791
Provider Name (Legal Business Name): LOVELL COUNSELING, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5457 TWIN KNOLLS RD STE 300N-16
COLUMBIA MD
21045-3259
US

IV. Provider business mailing address

5457 TWIN KNOLLS RD STE 300N-16
COLUMBIA MD
21045-3259
US

V. Phone/Fax

Practice location:
  • Phone: 410-227-5059
  • Fax: 443-583-3880
Mailing address:
  • Phone: 410-227-5059
  • Fax: 443-583-3880

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 Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0855X
TaxonomyAdolescent and Children Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARCIE A LOVELL
Title or Position: OWNER
Credential: LCSW-C
Phone: 410-227-5059