MEDICARE: BARBARA LAVI PSYD

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
1	103TC0700X	Clinical Psychologist	002372	CT
2	103TC0700X	Clinical Psychologist	4324	MA

General Provider Information

NPI Number	:	1295876027
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARBARA LAVI PSYD

Provider Business Mailing Address
First Line	:	15 BEAVERBROOK RD
Second Line	:
City	:	WESTON
State	:	CT
Zip	:	06883-1804
Country	:	US
Telephone Number	:	203-226-8999
Fax Number	:	203-557-3439

Provider Business Practice Location Address
First Line	:	15 BEAVERBROOK RD
Second Line	:
City	:	WESTON
State	:	CT
Zip	:	06883-1804
Country	:	US
Telephone Number	:	203-226-8999
Fax Number	:	203-557-3439

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	07/08/2007

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