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General NPI Number Information
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NPI Number | 1801837448
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Entity Type | Individual
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Provider Name | CHARLES DRAVO LOVELOCK L.C.S.W.
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Gender | Male
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Dates
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Enumeration Date | 06/08/2006
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Last Update Date | 03/24/2008
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Provider Practice Location Address
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Address Line | 3584 JEROME AVE
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City | BRONX
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State | NY
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Zip | 10467-1052
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Country | US
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Telephone | 718-653-1537
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Fax | 718-882-1426
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Provider Business Mailing Address
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Address Line | PO BOX 31094
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City | HARTFORD
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State | CT
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Zip | 06150-1094
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Country | US
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Telephone | 800-989-6446
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Fax | 518-952-8287
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 072394
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License Number State | NY
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