Provider Demographics
NPI:1548345713
Name:LAVOIE, ALLAN L (PHD)
Entity type:Individual
Prefix:DR
First Name:ALLAN
Middle Name:L
Last Name:LAVOIE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2016
Mailing Address - Street 2:
Mailing Address - City:ELKINS
Mailing Address - State:WV
Mailing Address - Zip Code:26241-2016
Mailing Address - Country:US
Mailing Address - Phone:304-636-1811
Mailing Address - Fax:304-637-7299
Practice Address - Street 1:100 3RD ST
Practice Address - Street 2:
Practice Address - City:ELKINS
Practice Address - State:WV
Practice Address - Zip Code:26241-3831
Practice Address - Country:US
Practice Address - Phone:304-636-1811
Practice Address - Fax:304-637-7299
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-26
Last Update Date:2010-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV0163262000Medicaid