Provider Demographics
NPI:1982953790
Name:CHEVALIER, LAWRENCE PAUL (PSYD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:PAUL
Last Name:CHEVALIER
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7333 MERRICK CREEK RD
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25702-9767
Mailing Address - Country:US
Mailing Address - Phone:304-633-8722
Mailing Address - Fax:
Practice Address - Street 1:1415 6TH AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:WV
Practice Address - Zip Code:25701-2420
Practice Address - Country:US
Practice Address - Phone:304-523-1142
Practice Address - Fax:304-523-2966
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1093103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist