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General NPI Number Information
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NPI Number | 1063648335
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Entity Type | Individual
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Provider Name | KRISTIE R LOVEALL M.ED., LPC
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Gender | Female
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Dates
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Enumeration Date | 06/01/2009
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Last Update Date | 04/17/2014
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Provider Practice Location Address
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Address Line | 63 OLD 63 N. STE 105
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City | COLUMBIA
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State | MO
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Zip | 65202-3900
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Country | US
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Telephone | 573-499-0011
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Fax |
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Provider Business Mailing Address
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Address Line | 1703 TIDEWATER DR
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City | COLUMBIA
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State | MO
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Zip | 65202-6423
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Country | US
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Telephone | 573-289-7526
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 2007010646
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 2007010646
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License Number State | MO
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