Healthcare Provider Details

I. General information

NPI: 1265509954
Provider Name (Legal Business Name): GERALD DAVID LOVETT D. MIN.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 09/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5731 LYONS VIEW PIKE SUITE 202
KNOXVILLE TN
37919-6434
US

IV. Provider business mailing address

PO BOX 10944
KNOXVILLE TN
37939-0944
US

V. Phone/Fax

Practice location:
  • Phone: 865-584-9001
  • Fax:
Mailing address:
  • Phone: 865-584-9001
  • Fax: 865-584-3998

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP1600X
TaxonomyPastoral Counselor
License Number0000000011
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0000001195
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number3205
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: