Lavender Soul Care

Primary specialty

Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X

Legal business name

LAVENDER SOUL CARE

Practice address

3930 Marron Ave
Long Beach, CA 90807-3614

Phone

(562) 641-5638

NPI assigned

Jun 15, 2021

Organization subpart

No

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

Authorized official

Name

Mrs. Ginger L Wilkerson, LMFT

Title

Owner

Phone

(562) 413-7028

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• Lavender Soul Care Former legal business name

Electronic endpoints 2

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

{
    "created_epoch": "1623715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1623715200000",
    "number": "1871161844",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3930 MARRON AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073614",
            "telephone_number": "562-413-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3930 MARRON AVE",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908073614",
            "telephone_number": "562-641-5638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER SOUL CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-06-15",
        "last_updated": "2021-06-15",
        "certification_date": "2021-06-11",
        "status": "A",
        "authorized_official_last_name": "WILKERSON",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "562-413-7028",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NONE",
            "identifier": "NONE",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "www.gingerlavendertherapy.com",
            "affiliation": "N",
            "endpointDescription": "Website",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "gingermft@gmail.com",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "3930 Marron Ave",
            "city": "Long Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "908073614",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Internet",
            "affiliation": "N",
            "endpointDescription": "Simple Practice",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3930 Marron Ave",
            "city": "Long Beach",
            "state": "CA",
            "country_code": "US",
            "postal_code": "908073614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Lavender Soul Care",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Laura a Russell MD Inc
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• Patrick Lauro, O.D.
• Lavender Healing Collective, Inc.
• Shaina Lavergne
• Antonio Lavermon
• Monica Lavian, D.O.
• Nathan Ernest Lavid, M.D.
• Alyce Dunn Laviolette, M.F.T.

• Mental Health Clinic/Center (Including Community Mental Health Center) in Long Beach, CA
• Providers in Long Beach, CA by specialty
• Mental Health Clinic/Center (Including Community Mental Health Center) in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2021; 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.