Provider Demographics
NPI:1689553737
Name:LAVIN, CORINNE ELIZABETH
Entity type:Individual
Prefix:
First Name:CORINNE
Middle Name:ELIZABETH
Last Name:LAVIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7639 PIPER CIR
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:FL
Mailing Address - Zip Code:32583-8676
Mailing Address - Country:US
Mailing Address - Phone:910-705-1765
Mailing Address - Fax:
Practice Address - Street 1:1913 HIGHWAY 87
Practice Address - Street 2:
Practice Address - City:NAVARRE
Practice Address - State:FL
Practice Address - Zip Code:32566-1017
Practice Address - Country:US
Practice Address - Phone:850-816-8122
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLIMH26065101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health