Lavender Hills Psychotherapy LLC

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

05723 Issued in MD

Legal business name

LAVENDER HILLS PSYCHOTHERAPY LLC

Practice address

11140 Rockville Pike Ste 400
North Bethesda, MD 20852-3104

Phone

(240) 230-6668

NPI assigned

Jul 16, 2018

Organization subpart

No

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

Authorized official

Name

Paula Henriquez, PSY.D.

Title

Clinical Psychologist

Phone

(240) 230-6668

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1531699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1548288000000",
    "number": "1518443274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11140 ROCKVILLE PIKE STE 400",
            "city": "N BETHESDA",
            "state": "MD",
            "postal_code": "208523104",
            "telephone_number": "240-230-6668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11140 ROCKVILLE PIKE STE 400",
            "city": "NORTH BETHESDA",
            "state": "MD",
            "postal_code": "208523104",
            "telephone_number": "240-230-6668"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER HILLS PSYCHOTHERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-07-16",
        "last_updated": "2019-01-24",
        "status": "A",
        "authorized_official_last_name": "HENRIQUEZ",
        "authorized_official_first_name": "PAULA",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "240-230-6668",
        "authorized_official_credential": "PSY.D."
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MD",
            "license": "05723",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLINICAL PSYCHOLOGIST",
            "identifier": "1598071433",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Clinical Child & Adolescent Psychologist in North Bethesda, MD
• Providers in North Bethesda, MD by specialty
• Clinical Child & Adolescent Psychologist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.