Provider Demographics
NPI:1083593370
Name:LAVENDER HOUSE PSYCHOLOGY, LLC
Entity type:Organization
Organization Name:LAVENDER HOUSE PSYCHOLOGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED CLINICAL PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KARMEN
Authorized Official - Middle Name:
Authorized Official - Last Name:THULIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:720-675-7050
Mailing Address - Street 1:5626 HOMESIDE AVE
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90016-3226
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1177 N GRANT ST # 308
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80203-2362
Practice Address - Country:US
Practice Address - Phone:720-772-9969
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-29
Last Update Date:2025-08-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinicalGroup - Single Specialty