NPI Profile for JEROME LAVIS in FORT STEWART, GA.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Professional |
101YP2500X | |||
Addiction (Substance Use Disorder) |
101YA0400X |
| NPI Number | 1356464267 |
|
| Status | Active | |
| Credentials | LPC-S, LMFT, LCDC | |
| Entity | Individual | |
| Enumeration date | 04/06/2007 | |
| Last updated | 11/09/2022 - About 4 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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JEROME LAVIS
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