Organization Active NPI

Lovely Behavioral Health Services LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • Woodbury, MN
National Provider Identifier
1245007301
Registry record updated Dec 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LOVELY BEHAVIORAL HEALTH SERVICES LLC
Practice address
2042 Wooddale Dr Ste 250
Woodbury, MN 55125-4421
Phone
(651) 615-4042
NPI assigned
Dec 8, 2023
Last updated
Dec 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Loveline NguNPI 1891309969
Title
Owner
Phone
(651) 615-4042

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X NU Primary

Addresses

Primary practice location

2042 Wooddale Dr Ste 250
Woodbury, MN 55125-4421

Mailing address

2042 Wooddale Dr Ste 250
Woodbury, MN 55125-4421

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240108000278 MN Part B Supplier - Clinic/Group Practice 2365893070 Receives reassigned benefits from 1 practitioner
Practice locations: Woodbury, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1701993600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1701993600000",
    "number": "1245007301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2042 WOODDALE DR STE 250",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2042 WOODDALE DR STE 250",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551254421",
            "telephone_number": "651-615-4042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOVELY BEHAVIORAL HEALTH SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-08",
        "last_updated": "2023-12-08",
        "certification_date": "2023-12-08",
        "status": "A",
        "authorized_official_last_name": "NGU",
        "authorized_official_first_name": "LOVELINE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "651-615-4042"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.