Provider Demographics
NPI:1407118425
Name:LAVINE, ROBIN (LMHC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:LAVINE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:406 NW 68TH AVE APT 415
Mailing Address - Street 2:
Mailing Address - City:PLANTATION
Mailing Address - State:FL
Mailing Address - Zip Code:33317-7526
Mailing Address - Country:US
Mailing Address - Phone:954-854-1482
Mailing Address - Fax:
Practice Address - Street 1:406 NW 68TH AVE APT 415
Practice Address - Street 2:
Practice Address - City:PLANTATION
Practice Address - State:FL
Practice Address - Zip Code:33317-7526
Practice Address - Country:US
Practice Address - Phone:954-854-1482
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-14
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005053-1101YM0800X
FLMH12736101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health