Organization
LAVENDER ROOTS COUNSELING, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAITLIN MARIE SILVEIRA LMHC (OWNER)
(781) 460-9477
Entity
Organization
Contact information
Practice address
5619 NW 86TH ST, JOHNSTON, IA 50131-1819
(781) 460-9477
Mailing address
2309 NE 6TH ST, GRIMES, IA 50111-2117
(781) 460-9477
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962618355
—
IA
Enumeration date
12/27/2023
Last updated
12/27/2023
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