Provider Demographics
NPI:1295876027
Name:LAVI, BARBARA (PSYD)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:
Last Name:LAVI
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 BEAVERBROOK RD
Mailing Address - Street 2:
Mailing Address - City:WESTON
Mailing Address - State:CT
Mailing Address - Zip Code:06883-1804
Mailing Address - Country:US
Mailing Address - Phone:203-226-8999
Mailing Address - Fax:203-557-3439
Practice Address - Street 1:15 BEAVERBROOK RD
Practice Address - Street 2:
Practice Address - City:WESTON
Practice Address - State:CT
Practice Address - Zip Code:06883-1804
Practice Address - Country:US
Practice Address - Phone:203-226-8999
Practice Address - Fax:203-557-3439
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002372103TC0700X
MA4324103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical