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NPI Code Detail

MEDICARE: MS. STEFANIE B. LAVA PSY.D.

MEDICARE: MS. STEFANIE B. LAVA PSY.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1103TC0700XClinical Psychologist9346MA

General Provider Information

NPI Number : 1144510835
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. STEFANIE B. LAVA PSY.D.
Provider Business Mailing Address
First Line : 110 ROBIN RD
Second Line :
City : PORTSMOUTH
State : RI
Zip : 02871-3711
Country : US
Telephone Number : 973-768-0856
Fax Number : 866-868-3006
Provider Business Practice Location Address
First Line : 1082 DAVOL ST STE 201
Second Line :
City : FALL RIVER
State : MA
Zip : 02720-1124
Country : US
Telephone Number : 973-768-0856
Fax Number : 866-868-3006
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/14/2011
Last Update Date : 12/08/2020

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