Lavender Avenue Therapeutics, PC

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

4548 Issued in NC

Legal business name

LAVENDER AVENUE THERAPEUTICS, PC

Practice address

210 W Lavender Ave
Durham, NC 27704-4251

Phone

(919) 302-2308

NPI assigned

May 20, 2015

Organization subpart

No

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

Authorized official

Name

Dr. Jasmine T Irvin, PHDNPI 1053675785

Title

President

Phone

(919) 302-2308

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jasmine Ti Irvin, PHD

  • Clinical Psychologist
  • Durham, NC
  • NPI 1053675785
  NPD (past) Authorized official

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1432080000000",
    "number": "1891174181",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 W LAVENDER AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277044251",
            "telephone_number": "919-302-2308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 W LAVENDER AVE",
            "city": "DURHAM",
            "state": "NC",
            "postal_code": "277044251",
            "telephone_number": "919-302-2308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER AVENUE THERAPEUTICS, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-20",
        "last_updated": "2015-05-20",
        "status": "A",
        "authorized_official_last_name": "IRVIN",
        "authorized_official_first_name": "JASMINE",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "919-302-2308",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "NC",
            "license": "4548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura J. Bach PLLC
• Laura L. Chamberlain, DDS, PA
• Laurent Pilon, DMD, PA
• Evangeline Lausier, M.D.
• Emmanuelle Elizabeth Mitra Lavassani, MD
• Kevin M. Lavery, PA-C
• Peter Joseph Lavin, M.D.
• Nanette Louise Lavoie-Vaughan, ARNP-C
• Lawrence a Dunn, MD, PLLC
• Kiera Talexus Lawrence, LCSW-A

• Clinical Psychologist in Durham, NC
• Providers in Durham, NC by specialty
• Clinical Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2015; 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.