Provider Demographics
NPI:1366515587
Name:LAVIN, THOMAS CHARLES (MFT, LCADC)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:CHARLES
Last Name:LAVIN
Suffix:
Gender:M
Credentials:MFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7401 MONET CT
Mailing Address - Street 2:
Mailing Address - City:SUN VALLEY
Mailing Address - State:NV
Mailing Address - Zip Code:89433-6681
Mailing Address - Country:US
Mailing Address - Phone:775-323-3330
Mailing Address - Fax:
Practice Address - Street 1:557 CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-1449
Practice Address - Country:US
Practice Address - Phone:775-323-3330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV00231L101YA0400X
NV276-LC101YA0400X
NV0824106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV00231LOtherLADC
NV0824OtherM,F.T.