Provider Demographics
NPI:1881115236
Name:LAVENDER CONSULTING AND COUNSELING SERVICES, LLC
Entity type:Organization
Organization Name:LAVENDER CONSULTING AND COUNSELING SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DESIREE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOWERY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:302-562-7267
Mailing Address - Street 1:1148 PULASKI HWY STE 327
Mailing Address - Street 2:
Mailing Address - City:BEAR
Mailing Address - State:DE
Mailing Address - Zip Code:19701-1306
Mailing Address - Country:US
Mailing Address - Phone:302-562-7267
Mailing Address - Fax:302-416-5095
Practice Address - Street 1:2055 LIMESTONE RD STE 200B
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19808-5536
Practice Address - Country:US
Practice Address - Phone:302-562-7267
Practice Address - Fax:302-416-5095
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DESIREE LOWERY, LCSW
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2017-07-06
Last Update Date:2017-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00010481041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty