Provider Demographics
NPI:1699809061
Name:LAVIN, NANETTE MARIE (LMSW)
Entity Type:Individual
Prefix:
First Name:NANETTE
Middle Name:MARIE
Last Name:LAVIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:NANETTE
Other - Middle Name:MARIE
Other - Last Name:TORCHIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:23 STUART ST
Mailing Address - Street 2:
Mailing Address - City:LYNBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11563-1111
Mailing Address - Country:US
Mailing Address - Phone:516-561-9462
Mailing Address - Fax:
Practice Address - Street 1:1770 STILLWELL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-6409
Practice Address - Country:US
Practice Address - Phone:718-652-9790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY051861-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker