De'Trece Atalie Lavender, NCC. LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC14772 Issued in MD

Practice address

4904 York Rd Unit 4506
Baltimore, MD 21212-7501

Phone

(240) 565-0569

Fax

(240) 427-9390

NPI assigned

Jan 7, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MD

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mental Health Specialty Group PA

  • Mental Health Counselor
  • Durham, NC
  • NPI 1801472634

  MD, Professional

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724976000000",
    "number": "1073274387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4904 YORK RD UNIT 4506",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212127501",
            "telephone_number": "240-565-0569",
            "fax_number": "240-427-9390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4904 YORK RD UNIT 4506",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212127501",
            "telephone_number": "240-565-0569",
            "fax_number": "240-427-9390"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8101 Sandy Spring Rd Ste 250",
            "address_purpose": "LOCATION",
            "city": "Laurel",
            "state": "MD",
            "postal_code": "207073527",
            "country_code": "US",
            "telephone_number": "667-228-8397",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4359 Northview Dr",
            "address_purpose": "LOCATION",
            "city": "Bowie",
            "state": "MD",
            "postal_code": "207162603",
            "country_code": "US",
            "telephone_number": "240-565-0569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LAVENDER",
        "first_name": "DE'TRECE",
        "middle_name": "ATALIE",
        "credential": "NCC. LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-07",
        "last_updated": "2024-08-30",
        "certification_date": "2024-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC14772",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margo D Lauterbach, M.D.
• Viah Lauture
• Janice M Laux, PT
• Rochelle L Lauzon
• Danica Lavarias, DPT
• Danielle Nina Lavere, MS, OTR/L
• Anthony Laverette, ADT1562
• Lavern Jones MD LLC
• Hannah Lavi
• Deborah Lavian, OTRL

• Professional Counselor in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Professional Counselor in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.