Organization Active NPI

Lavender Grove Therapy Services LLC

  • Clinical Social Worker
  • Grand Blanc, MI
National Provider Identifier
1669367249
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LAVENDER GROVE THERAPY SERVICES LLC
Practice address
8308 Office Park Dr Ste 1
Grand Blanc, MI 48439-2075
Phone
(810) 444-3104
Fax
(810) 221-0287
NPI assigned
Jun 12, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Authorized official

Name
Leah Katherine Stadel, LMSWNPI 1598374852
Title
Practice Owner/Clinical Therapist
Phone
(810) 444-3104

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

8308 Office Park Dr Ste 1
Grand Blanc, MI 48439-2075

Mailing address

8308 Office Park Dr Ste 1
Grand Blanc, MI 48439-2075
Phone (810) 444-3104

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250919001030 MI Part B Supplier - Clinic/Group Practice 1658875802 Receives reassigned benefits from 1 practitioner
Practice locations: Grand Blanc, MI

National Provider Directory

National Provider Directory

Locations

8308 Office Park Dr
Ste 1
Grand Blanc, MI 48439
Phone (810) 444-3104

Practitioners & affiliated clinicians

Practitioners 2

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": "1749686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1669367249",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8308 OFFICE PARK DR STE 1",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392075",
            "telephone_number": "810-444-3104",
            "fax_number": "810-221-0287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8308 OFFICE PARK DR STE 1",
            "city": "GRAND BLANC",
            "state": "MI",
            "postal_code": "484392075",
            "telephone_number": "810-444-3104",
            "fax_number": "810-221-0287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER GROVE THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-12",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "STADEL",
        "authorized_official_first_name": "LEAH",
        "authorized_official_middle_name": "KATHERINE",
        "authorized_official_title_or_position": "PRACTICE OWNER/CLINICAL THERAPIST",
        "authorized_official_telephone_number": "810-444-3104",
        "authorized_official_credential": "LMSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Blanc, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; 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.

Verify at the official NPI Registry.