Healthcare Provider Details

I. General information

NPI: 1275979510
Provider Name (Legal Business Name): LOVEJOY M ANDERSON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LOVIE ANDERSON RN

II. Dates (important events)

Enumeration Date: 05/14/2013
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 WILLOW DR
EUCLID OH
44132-2026
US

IV. Provider business mailing address

603 WILLOW DR
EUCLID OH
44132-2026
US

V. Phone/Fax

Practice location:
  • Phone: 216-256-1971
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberRN.527440
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: