Provider Demographics
NPI:1659034817
Name:LAVIGNE, CHELSEA C (IBCLC)
Entity Type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:C
Last Name:LAVIGNE
Suffix:
Gender:F
Credentials:IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 HIGHLAND HTS
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:ME
Mailing Address - Zip Code:04364-1508
Mailing Address - Country:US
Mailing Address - Phone:207-530-0233
Mailing Address - Fax:
Practice Address - Street 1:17 HIGHLAND HTS
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:ME
Practice Address - Zip Code:04364-1508
Practice Address - Country:US
Practice Address - Phone:207-530-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-14
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEL-303800174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RN