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Contact Information

ROGER J LAVINE JR, PSYD.
222 COMMERCIAL BLVD STE 200
LAUDERDALE BY THE SEA, FL33308-4483
 Phone: 954-716-6702
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
 

Exercise & Sports

103TE1100X 62 Psychologist, Clinical
 

Family

103TF0000X 62 Psychologist, Clinical
 

Group Psychotherapy

103TP2701X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for ROGER J LAVINE JR · (Male)

NPI # 1336784875
Status Active
Credentials PSYD.
Entity Individual
Enumeration date 11/07/2019
Last updated 11/07/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • FL License # PY10647
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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