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General NPI Number Information
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NPI Number | 1851757140
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Entity Type | Individual
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Provider Name | TIFFANY TRELETTE LOVELADY WELLS DPC, LPC, NCC, NCSC
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Gender | Female
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Dates
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Enumeration Date | 01/03/2016
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Last Update Date | 10/26/2023
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Provider Practice Location Address
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Address Line | 2149 HIGHWAY 471
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City | BRANDON
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State | MS
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Zip | 39047-8748
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Country | US
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Telephone | 769-208-4992
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Fax | 769-207-7305
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Provider Business Mailing Address
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Address Line | 217 WESTFIELD RD
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City | RIDGELAND
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State | MS
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Zip | 39157-9753
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Country | US
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Telephone | 769-234-4153
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Fax | 769-207-7305
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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 | 2039
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License Number State | MS
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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 | 2039
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License Number State | MS
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