Provider Demographics
NPI:1710101449
Name:LAVIN, JOHN FRANCIS (LCSW-R)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:FRANCIS
Last Name:LAVIN
Suffix:
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48-01 42ND STREET
Mailing Address - Street 2:APT. 2D
Mailing Address - City:SUNNYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11104-3117
Mailing Address - Country:US
Mailing Address - Phone:347-684-0082
Mailing Address - Fax:
Practice Address - Street 1:6433 99TH ST
Practice Address - Street 2:BASEMENT OFFICE
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-3563
Practice Address - Country:US
Practice Address - Phone:347-684-0082
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0050081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical