Provider Demographics
NPI:1356526180
Name:BILLION, LAWRENCE H (PHD)
Entity type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:H
Last Name:BILLION
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:
Other - Last Name:BILLION
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHD
Mailing Address - Street 1:PO BOX 273618
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33427-3618
Mailing Address - Country:US
Mailing Address - Phone:561-395-0027
Mailing Address - Fax:
Practice Address - Street 1:500 NE SPANISH RIVER BLVD
Practice Address - Street 2:32B
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4515
Practice Address - Country:US
Practice Address - Phone:561-395-0027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-28
Last Update Date:2012-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY2056103TA0400X, 103TB0200X, 103TC0700X, 103TC2200X, 103TF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0400XBehavioral Health & Social Service ProvidersPsychologistAddiction (Substance Use Disorder)
No103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral
No103TC2200XBehavioral Health & Social Service ProvidersPsychologistClinical Child & Adolescent
No103TF0000XBehavioral Health & Social Service ProvidersPsychologistFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLR99977Medicare UPIN
FL75596Medicare PIN