Individual
MELISSA LAVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PSY.D
Contact information
Practice address
3333 CLARK RD STE 110, SARASOTA, FL 34231-8437
(858) 859-0822
(941) 924-7546
Mailing address
3333 CLARK RD STE 110, SARASOTA, FL 34231-8437
(858) 859-0822
(941) 924-7546
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
103TA0700X
Adult Development & Aging Psychologist
—
—
103TB0200X
Cognitive & Behavioral Psychologist
—
—
103TC0700X
Clinical Psychologist
1359
NH
103TC1900X
Counseling Psychologist
—
—
103TC2200X
Clinical Child & Adolescent Psychologist
—
—
103TF0000X
Family Psychologist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1359
STATE OF NH BOARD OF PSYCHOLOGIST
NH
05
—
3104605
—
NH
01
—
PY10924
FL DEPARTMENT OF HEALTH DIVISION OF MEDICAL QUALITY ASSURANCE
FL
Enumeration date
05/11/2011
Last updated
10/04/2023
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