Provider Demographics
NPI:1164293502
Name:LAVENDER SPRINGS BEHAVIORAL HEALTH LLC
Entity Type:Organization
Organization Name:LAVENDER SPRINGS BEHAVIORAL HEALTH LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER / CHIEF OPERATIONS OFFIC
Authorized Official - Prefix:MRS
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:GREEN SINGER
Authorized Official - Suffix:
Authorized Official - Credentials:MS LPC LCPC NCC
Authorized Official - Phone:913-523-6081
Mailing Address - Street 1:PO BOX 19114
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66285-9114
Mailing Address - Country:US
Mailing Address - Phone:913-523-6081
Mailing Address - Fax:913-392-7199
Practice Address - Street 1:15310 W 89TH PL
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66219-1128
Practice Address - Country:US
Practice Address - Phone:913-523-6081
Practice Address - Fax:913-392-7199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health