Charles Lavine, LPC-S

NPI 1447482641 · on the registry since 2009 · sole proprietor

Practice

Address: 2701 Burchill Rd N
Fort Worth, TX 76105
Phone: (817) 534-0814
Fax: (817) 536-1556
Organisation at this address: Catholic Charities Of Fort Worth, Inc
Catholic Charities Diocese Of Fort Worth Inc
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 5

Registry record

Primary taxonomy: 101YM0800X
101YM0800X
Licence states on file: TX
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2009-08-20

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Texas