Michael Peter Lavigne

Key facts

NPI

1013567635

Entity type

Individual (NPI type 1)

Primary specialty

Addiction (Substance Use Disorder) Counselor 101YA0400X

Practice address

705 W la Veta Ave Ste 208
Orange, CA 92868-4448

Phone

(714) 532-9295

Fax

(714) 532-9291

NPI assigned

Sep 16, 2019

Sex

Male

Sole proprietor

Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Twin Town Corporation Substance Use Disorder Rehabilitation Clinic/Center · Orange, CA · NPI 1407282247
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 10, 2020.

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594339200000",
    "number": "1013567635",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE STE 208",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684448",
            "telephone_number": "714-532-9295",
            "fax_number": "714-532-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "705 W LA VETA AVE STE 208",
            "city": "ORANGE",
            "state": "CA",
            "postal_code": "928684448",
            "telephone_number": "714-532-9295",
            "fax_number": "714-532-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVIGNE",
        "first_name": "MICHAEL",
        "middle_name": "PETER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-09-16",
        "last_updated": "2020-07-10",
        "certification_date": "2020-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "CA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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All providers in Orange, CA · Addiction (Substance Use Disorder) Counselor in California