Healthcare Provider Details

I. General information

NPI: 1083520316
Provider Name (Legal Business Name): AMANDA LOVEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1250 FARROW RD
MEMPHIS TN
38116-7116
US

IV. Provider business mailing address

27 RANDOLPH RD
HOWELL NJ
07731-8611
US

V. Phone/Fax

Practice location:
  • Phone: 718-506-1115
  • Fax:
Mailing address:
  • Phone: 732-712-2215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number1517
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: