Lavender Road Therapy Services, LLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

LAVENDER ROAD THERAPY SERVICES, LLC

Practice address

4611 S 96TH St Ste 174
Omaha, NE 68127-1242

Phone

(402) 320-2336

NPI assigned

May 22, 2026

Organization subpart

No

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

Authorized official

Name

Angela A Kenedy, LIMHP, LCSW, LADCNPI 1881958338

Title

Therapist/Owner

Phone

(402) 320-2336

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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.

• Angela A Kenedy, LIMHP, LCSW, LADC

  • Clinical Social Worker
  • Omaha, NE
  • NPI 1881958338
  NPD Authorized official

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

{
    "created_epoch": "1779408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1779494400000",
    "number": "1942130638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 174",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271242",
            "telephone_number": "402-320-2336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4611 S 96TH ST STE 174",
            "city": "OMAHA",
            "state": "NE",
            "postal_code": "681271242",
            "telephone_number": "402-320-2336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAVENDER ROAD THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-05-22",
        "last_updated": "2026-05-23",
        "certification_date": "2026-05-23",
        "status": "A",
        "authorized_official_last_name": "KENEDY",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "THERAPIST/OWNER",
        "authorized_official_telephone_number": "402-320-2336",
        "authorized_official_credential": "LIMHP, LCSW, LADC"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tracy Lautt, R.D.H.
• Caleb J Lauvetz
• Kendal Carann Laux, M.D.
• Jack Lavallie
• Alicia Lavelle
• Mackenzie Lavigne, RN
• Jacob Eugene Laville
• Sara Laville, PHARMD
• Erin Nicole Lavin, CNM
• Lisa Lavine

• Adult Mental Health Clinic/Center in Omaha, NE
• Providers in Omaha, NE by specialty
• Adult Mental Health Clinic/Center in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 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.