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Individual

MR. PAUL ANTHONY LAVAN III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RSS,COACH

Contact information

Practice address
846 WETHERSFIELD AVE STE 101, HARTFORD, CT 06114-3180
(860) 962-1803
Mailing address
627 BROAD ST APT D, HARTFORD, CT 06106-4630
(860) 962-1803

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
CT
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CT
106S00000X
Behavior Technician
CT
251B00000X
Case Management Agency
CT

Other

Enumeration date
10/03/2025
Last updated
10/03/2025
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