| Lavender Springs Behavioral Health Llc | |
|
15310 W 89th Pl Lenexa KS 66219-1128 | |
| (913) 523-6081 | |
| (913) 392-7199 |
| Full Name | Lavender Springs Behavioral Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 15310 W 89th Pl, Lenexa, Kansas |
| Authorized Official Name and Position | Nicole Green Singer (PART OWNER / CHIEF OPERATIONS OFFIC) |
| Authorized Official Contact | 9135236081 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Springs Behavioral Health Llc Po Box 19114 Lenexa KS 66285-9114 Ph: (913) 523-6081 | Lavender Springs Behavioral Health Llc 15310 W 89th Pl Lenexa KS 66219-1128 Ph: (913) 523-6081 |
| NPI Number | 1164293502 |
|---|---|
| Provider Enumeration Date | 01/15/2024 |
| Last Update Date | 01/15/2024 |
| Certification Date | 01/14/2024 |
| Medicare PECOS PAC ID | 6406296714 |
|---|---|
| Medicare Enrollment ID | O20240503001807 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164293502 | NPI | - | NPPES |
| Provider Name | Nicole Dawn Green Singer |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1912392234 PECOS PAC ID: 4587004890 Enrollment ID: I20240503002001 |
| Provider Name | Brandon Mark Cunningham |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1588320295 PECOS PAC ID: 8224478433 Enrollment ID: I20240503002290 |
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