Active NPI
Loren N Laviolette, EDD
- Psychologist
- Philadelphia, PA
National Provider Identifier
1336350081
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PS003802L
- Practice address
- 255 South 17TH Street
Suite 1605 Medical Tower Building
Philadelphia, PA 19103 - Phone
- (215) 545-5493
- Fax
- (215) 545-5494
- NPI assigned
- May 24, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PS003802L | PA | Primary |
Addresses
Primary practice location
255 South 17TH Street
Suite 1605 Medical Tower Building
Philadelphia, PA 19103
Mailing address
255 South 17TH Street
Suite 1605 Medical Tower Building
Philadelphia, PA 19103
Phone (215) 545-5493
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PS003802L | PA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179964800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1336350081",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "255 SOUTH 17TH STREET",
"address_2": "SUITE 1605 MEDICAL TOWER BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19103",
"telephone_number": "215-545-5493",
"fax_number": "215-545-5494"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "255 SOUTH 17TH STREET",
"address_2": "SUITE 1605 MEDICAL TOWER BUILDING",
"city": "PHILADELPHIA",
"state": "PA",
"postal_code": "19103",
"telephone_number": "215-545-5493",
"fax_number": "215-545-5494"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LAVIOLETTE",
"first_name": "LOREN",
"middle_name": "N",
"credential": "EDD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "PA",
"license": "PS003802L",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Philadelphia, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.