Organization Active NPI

Lavender Roots Counseling, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Johnston, IA
National Provider Identifier
1750150041
Registry record updated Dec 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
LAVENDER ROOTS COUNSELING, LLC
Practice address
5619 NW 86TH St
Johnston, IA 50131-1819
Phone
(781) 460-9477
NPI assigned
Dec 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2023

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

Authorized official

Name
Caitlin Marie Silveira, LMHC
Title
Owner
Phone
(781) 460-9477

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5619 NW 86TH St
Johnston, IA 50131-1819

Mailing address

2309 NE 6TH St
Grimes, IA 50111-2117
Phone (781) 460-9477

Other identifiers 1

IdentifierTypeStateIssuer
1962618355MedicaidIA

National Provider Directory

National Provider Directory

Locations

5619 NW 86th St
Johnston, IA 50131
Phone (515) 218-9160

Practitioners & affiliated clinicians

Practitioners 1

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": "1703635200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1703635200000",
    "number": "1750150041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 NE 6TH ST",
            "city": "GRIMES",
            "state": "IA",
            "postal_code": "501112117",
            "telephone_number": "781-460-9477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5619 NW 86TH ST",
            "city": "JOHNSTON",
            "state": "IA",
            "postal_code": "501311819",
            "telephone_number": "781-460-9477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER ROOTS COUNSELING, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-12-27",
        "last_updated": "2023-12-27",
        "certification_date": "2023-12-27",
        "status": "A",
        "authorized_official_last_name": "SILVEIRA",
        "authorized_official_first_name": "CAITLIN",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "781-460-9477",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962618355",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnston, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2023; 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.