Provider Demographics
NPI:1043640857
Name:PATRICIA LAVELLE LLC
Entity Type:Organization
Organization Name:PATRICIA LAVELLE LLC
Other - Org Name:LAVELLE & ASSOCIATES
Other - Org Type:Other Name
Authorized Official - Title/Position:DIRECTOR/ MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:C
Authorized Official - Last Name:LAVELLE
Authorized Official - Suffix:
Authorized Official - Credentials:EDS
Authorized Official - Phone:605-275-2001
Mailing Address - Street 1:5024 S BUR OAK PL
Mailing Address - Street 2:SUITE 212
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-2236
Mailing Address - Country:US
Mailing Address - Phone:605-275-2001
Mailing Address - Fax:605-275-2019
Practice Address - Street 1:5024 S BUR OAK PL
Practice Address - Street 2:SUITE 212
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-2236
Practice Address - Country:US
Practice Address - Phone:605-275-2001
Practice Address - Fax:605-275-2019
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-11-14
Last Update Date:2013-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH 2066101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty