Provider Demographics
NPI:1477691020
Name:LAVIN, CHRISTOPHER MICHAEL (LADC, LCPC)
Entity Type:Individual
Prefix:MR
First Name:CHRISTOPHER
Middle Name:MICHAEL
Last Name:LAVIN
Suffix:
Gender:M
Credentials:LADC, LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:IMA EUROPE UNIT 29353
Mailing Address - Street 2:BOX 200
Mailing Address - City:APO
Mailing Address - State:AE
Mailing Address - Zip Code:09014
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:IMA EUROPE UNIT 29353
Practice Address - Street 2:BOX 200
Practice Address - City:APO
Practice Address - State:AE
Practice Address - Zip Code:09014
Practice Address - Country:US
Practice Address - Phone:496-221-5789
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-02
Last Update Date:2008-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC506101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)