| Lavender Roots Counseling, Llc | |
|
5619 Nw 86th St Johnston IA 50131-1819 | |
| (781) 460-9477 | |
| Not Available |
| Full Name | Lavender Roots Counseling, Llc |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 5619 Nw 86th St, Johnston, Iowa |
| Authorized Official Name and Position | Caitlin Marie Silveira (OWNER) |
| Authorized Official Contact | 7814609477 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Roots Counseling, Llc 2309 Ne 6th St Grimes IA 50111-2117 Ph: (781) 460-9477 | Lavender Roots Counseling, Llc 5619 Nw 86th St Johnston IA 50131-1819 Ph: (781) 460-9477 |
| NPI Number | 1750150041 |
|---|---|
| Provider Enumeration Date | 12/27/2023 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1750150041 | NPI | - | NPPES |
| 1962618355 | Medicaid | IA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
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