Provider Demographics
NPI:1376961185
Name:LOVEJOY, SELENA JUNE (LLPC)
Entity type:Individual
Prefix:
First Name:SELENA
Middle Name:JUNE
Last Name:LOVEJOY
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:632 N SHIAWASSEE ST
Mailing Address - Street 2:
Mailing Address - City:OWOSSO
Mailing Address - State:MI
Mailing Address - Zip Code:48867-2232
Mailing Address - Country:US
Mailing Address - Phone:989-723-0330
Mailing Address - Fax:517-676-5460
Practice Address - Street 1:632 N SHIAWASSEE ST
Practice Address - Street 2:
Practice Address - City:OWOSSO
Practice Address - State:MI
Practice Address - Zip Code:48867-2232
Practice Address - Country:US
Practice Address - Phone:989-723-0330
Practice Address - Fax:517-676-5460
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-31
Last Update Date:2017-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6401014300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional