Provider Demographics
NPI:1023714854
Name:CAVIN, RICHARD LAWRENCE (LMFT)
Entity type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:LAWRENCE
Last Name:CAVIN
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E BROADWAY # F
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92805-3910
Mailing Address - Country:US
Mailing Address - Phone:619-739-3854
Mailing Address - Fax:
Practice Address - Street 1:324 E BROADWAY # F
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92805-3910
Practice Address - Country:US
Practice Address - Phone:619-739-3854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-02
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA132703106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist