Provider Demographics
NPI:1043822430
Name:LAVIGNE, LAURAN LYNN
Entity type:Individual
Prefix:MRS
First Name:LAURAN
Middle Name:LYNN
Last Name:LAVIGNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LAURAN
Other - Middle Name:LYNN
Other - Last Name:MITCHELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:15 WALKER WAY
Mailing Address - Street 2:
Mailing Address - City:NORTH SCITUATE
Mailing Address - State:RI
Mailing Address - Zip Code:02857-1233
Mailing Address - Country:US
Mailing Address - Phone:401-497-8760
Mailing Address - Fax:
Practice Address - Street 1:68 NORTH FRONT STREET
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02740
Practice Address - Country:US
Practice Address - Phone:508-951-7035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-18
Last Update Date:2020-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health