| Lavender Mental Health Llc | |
|
835 E 2nd Ave Ste 271 Durango CO 81301-5488 | |
| (970) 426-0636 | |
| (970) 844-1722 |
| Full Name | Lavender Mental Health Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 835 E 2nd Ave Ste 271, Durango, Colorado |
| Authorized Official Name and Position | Sonya Brophy (OWNER) |
| Authorized Official Contact | 9704260636 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lavender Mental Health Llc 835 E 2nd Ave Ste 271 Durango CO 81301-5488 Ph: (970) 426-0636 | Lavender Mental Health Llc 835 E 2nd Ave Ste 271 Durango CO 81301-5488 Ph: (970) 426-0636 |
| NPI Number | 1386476968 |
|---|---|
| Provider Enumeration Date | 08/14/2024 |
| Last Update Date | 11/02/2024 |
| Certification Date | 11/02/2024 |
| Medicare PECOS PAC ID | 8527595628 |
|---|---|
| Medicare Enrollment ID | O20250102000002 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386476968 | NPI | - | NPPES |
| 1558905489 | Other | CO | NPI FOR INDIVIDUAL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Sonya Brophy |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558905489 PECOS PAC ID: 3476986290 Enrollment ID: I20191210001361 |
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