Individual
MR. JEROME LAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPC-S, LMFT, LCDC
Contact information
Practice address
1051 HARMON AVE, FORT STEWART, GA 31314
(912) 435-6965
Mailing address
1061 HARMON AVE, FORT STEWART, GA 31314-5641
(912) 435-6965
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
2630
TX
101YP2500X
Professional Counselor
Primary
11790
TX
Other
Enumeration date
04/06/2007
Last updated
11/09/2022
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