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General NPI Number Information
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NPI Number | 1366515587
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Entity Type | Individual
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Provider Name | THOMAS CHARLES LAVIN MFT, LCADC
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Gender | Male
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Dates
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Enumeration Date | 11/16/2006
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Last Update Date | 08/26/2019
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Provider Practice Location Address
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Address Line | 557 CALIFORNIA AVE
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City | RENO
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State | NV
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Zip | 89509-1449
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Country | US
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Telephone | 775-323-3330
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Fax |
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Provider Business Mailing Address
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Address Line | 7401 MONET CT
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City | SUN VALLEY
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State | NV
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Zip | 89433-6681
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Country | US
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Telephone | 775-323-3330
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Fax |
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 00231L
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 276-LC
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 0824
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License Number State | NV
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