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General NPI Number Information
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NPI Number | 1194259390
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Entity Type | Individual
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Provider Name | ANGELA FAYE LOVETT MED, LPC
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Gender | Female
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 10/06/2020
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Provider Practice Location Address
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Address Line | 108 N CLAY AVE STE 200
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City | KIRKWOOD
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State | MO
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Zip | 63122-4265
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Country | US
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Telephone | 314-315-0334
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Fax |
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Provider Business Mailing Address
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Address Line | 273 BRAESHIRE DR
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City | BALLWIN
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State | MO
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Zip | 63021-5660
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Country | US
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Telephone | 314-315-0334
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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 | 2014034535
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License Number State | MO
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