NPIMap

Organization Active NPI

Lavender New Jersey Psychiatric Nurse Practitioner PC

  • Psychiatric/Mental Health Nurse Practitioner
  • New York, NY
National Provider Identifier
1629922950
Registry record updated Feb 24, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
LAVENDER NEW JERSEY PSYCHIATRIC NURSE PRACTITIONER PC
Practice address
245 5TH Ave FL 3
New York, NY 10016-8728
Phone
(855) 444-7258
NPI assigned
Feb 24, 2026
Last updated
Feb 24, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 24, 2026

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

Authorized official

Name
Brighid GannonNPI 1366870453
Title
Ceo
Phone
(855) 444-7258

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

245 5TH Ave FL 3
New York, NY 10016-8728

Mailing address

22406 68TH Ave W
Mountlake Terrace, WA 98043-2372

National Provider Directory

National Provider Directory

Locations

971 US Highway 202 N
#8057
Branchburg, NJ 08876

Practitioners & affiliated clinicians

Practitioners 28

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 28

NPI Registry JSON

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

{
    "created_epoch": "1771891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771891200000",
    "number": "1629922950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22406 68TH AVE W",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245 5TH AVE FL 3",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100168728",
            "telephone_number": "855-444-7258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER NEW JERSEY PSYCHIATRIC NURSE PRACTITIONER PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-02-24",
        "last_updated": "2026-02-24",
        "certification_date": "2026-02-24",
        "status": "A",
        "authorized_official_last_name": "GANNON",
        "authorized_official_first_name": "BRIGHID",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "855-444-7258"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2026; 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.