Provider Demographics
NPI:1326099821
Name:LAVINSON, NORMAN B (PHD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:B
Last Name:LAVINSON
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 FRANKLIN CORNER RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08648-2548
Mailing Address - Country:US
Mailing Address - Phone:609-896-3790
Mailing Address - Fax:609-896-7078
Practice Address - Street 1:177 FRANKLIN CORNER RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:LAWRENCEVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08648-2548
Practice Address - Country:US
Practice Address - Phone:609-896-3790
Practice Address - Fax:609-896-7078
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
Not Answered103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
Not Answered103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
Not Answered103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ425189Medicare ID - Type Unspecified