Active NPI
Lavni, Inc
- Community/Behavioral Health Agency
- Henderson, NC
National Provider Identifier
1215673256
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Behavioral Health Agency
- Legal business name
- LAVNI, INC
- Practice address
- 804 S Garnett St
Henderson, NC 27536-4571 - Phone
- (980) 890-7522
- Fax
- (980) 890-7814
- NPI assigned
- May 11, 2022
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Marcus Azeh
- Title
- Incorporator
- Phone
- (843) 460-4292
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Behavioral Health Agency | 251S00000X | Primary | ||
| Mental Health Clinic/Center (Including Community Mental Health Center) | 261QM0801X |
Addresses
Primary practice location
804 S Garnett St
Henderson, NC 27536-4571
Mailing address
804 S Garnett St
Henderson, NC 27536-4571
Phone (980) 890-7522
Other practice location 1
8401 Mayland Dr Ste A
Richmond, VA 23294-4648
Phone (980) 890-7995
Other practice location 2
8735 Dunwoody Pl Ste N
Atlanta, GA 30350-2995
Phone (980) 890-7522
Other practice location 3
29 Broken Arrow Ct
Blythewood, SC 29016-8126
Phone (980) 890-7522
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 30018458450001 | Medicaid | VA |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | OFFICEALLY | Health Information Exchange (HIE) |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NC, GA, SC, VA
Enrollment records 4
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250904001318 | NC | Part B Supplier - Clinic/Group Practice | 9830691484 |
Receives reassigned benefits from 21 practitioners Practice locations: Henderson, NC |
| O20251223004474 | GA | Part B Supplier - Clinic/Group Practice | 9830691484 |
Receives reassigned benefits from 5 practitioners Practice locations: Atlanta, GA |
| O20260217002676 | SC | Part B Supplier - Clinic/Group Practice | 9830691484 |
Receives reassigned benefits from 1 practitioner Practice locations: Blythewood, SC |
| O20260313001703 | VA | Part B Supplier - Clinic/Group Practice | 9830691484 |
Receives reassigned benefits from 1 practitioner Practice locations: Richmond, VA |
National Provider Directory
National Provider DirectoryLocations
2500 Blue Ridge Rd
Ste 421
Raleigh, NC 27607
Phone (919) 787-1772
Practitioners & affiliated clinicians
Practitioners 27
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1652227200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1775088000000",
"number": "1215673256",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 S GARNETT ST",
"city": "HENDERSON",
"state": "NC",
"postal_code": "275364571",
"telephone_number": "980-890-7522"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "804 S GARNETT ST",
"city": "HENDERSON",
"state": "NC",
"postal_code": "275364571",
"telephone_number": "980-890-7522",
"fax_number": "980-890-7814"
}
],
"practiceLocations": [
{
"address_1": "8401 Mayland Dr Ste A",
"address_purpose": "LOCATION",
"city": "Richmond",
"state": "VA",
"postal_code": "232944648",
"country_code": "US",
"telephone_number": "980-890-7995",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "8735 Dunwoody Pl Ste N",
"address_purpose": "LOCATION",
"city": "Atlanta",
"state": "GA",
"postal_code": "303502995",
"country_code": "US",
"telephone_number": "980-890-7522",
"fax_number": "980-890-7814",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "29 Broken Arrow Ct",
"address_purpose": "LOCATION",
"city": "Blythewood",
"state": "SC",
"postal_code": "290168126",
"country_code": "US",
"telephone_number": "980-890-7522",
"fax_number": "980-890-7814",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"organization_name": "LAVNI, INC",
"organizational_subpart": "NO",
"enumeration_date": "2022-05-11",
"last_updated": "2026-04-02",
"certification_date": "2026-04-02",
"status": "A",
"authorized_official_last_name": "AZEH",
"authorized_official_first_name": "MARCUS",
"authorized_official_title_or_position": "INCORPORATOR",
"authorized_official_telephone_number": "843-460-4292"
},
"taxonomies": [
{
"code": "251S00000X",
"taxonomy_group": "",
"desc": "Community/Behavioral Health",
"state": null,
"license": null,
"primary": true
},
{
"code": "261QM0801X",
"taxonomy_group": "",
"desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "30018458450001",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "OFFICEALLY",
"affiliation": "N",
"use": "HIE",
"useDescription": "Health Information Exchange (HIE)",
"contentType": "CSV",
"contentTypeDescription": "CSV",
"address_1": "2500 Blue Ridge Rd Ste 421",
"city": "Raleigh",
"state": "NC",
"country_code": "US",
"postal_code": "276077516",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Henderson, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.