Provider Demographics
NPI:1033090972
Name:LOVELESS, CHELSIE
Entity type:Individual
Prefix:
First Name:CHELSIE
Middle Name:
Last Name:LOVELESS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 MIDLANE AVE
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:KY
Mailing Address - Zip Code:42501-4236
Mailing Address - Country:US
Mailing Address - Phone:606-485-8761
Mailing Address - Fax:
Practice Address - Street 1:107 MIDLANE AVE
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42501-4236
Practice Address - Country:US
Practice Address - Phone:606-485-8761
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-09
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY296610103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty