Provider Demographics
NPI:1225765837
Name:ARVANIS, LEXUS (LPC-A)
Entity Type:Individual
Prefix:
First Name:LEXUS
Middle Name:
Last Name:ARVANIS
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 NAEK RD STE 5A
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:CT
Mailing Address - Zip Code:06066-3990
Mailing Address - Country:US
Mailing Address - Phone:860-266-6629
Mailing Address - Fax:
Practice Address - Street 1:27 NAEK RD STE 4
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:CT
Practice Address - Zip Code:06066-3965
Practice Address - Country:US
Practice Address - Phone:860-431-8756
Practice Address - Fax:860-431-8756
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor