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General NPI Number Information
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NPI Number | 1710101449
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Entity Type | Individual
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Provider Name | JOHN FRANCIS LAVIN LCSW-R
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Gender | Male
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Dates
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Enumeration Date | 04/12/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6433 99TH ST BASEMENT OFFICE
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City | REGO PARK
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State | NY
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Zip | 11374-3563
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Country | US
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Telephone | 347-684-0082
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Fax |
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Provider Business Mailing Address
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Address Line | 48-01 42ND STREET APT. 2D
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City | SUNNYSIDE
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State | NY
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Zip | 11104-3117
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Country | US
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Telephone | 347-684-0082
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | R005008
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License Number State | NY
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