MEDICARE: LAVENDER HEART COUNSELING PLLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0850X	Adult Mental Health Clinic/Center

General Provider Information

NPI Number	:	1093647018
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAVENDER HEART COUNSELING PLLC

Provider Business Mailing Address
First Line	:	80 GARDEN CTR STE 156
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-1790
Country	:	US
Telephone Number	:	720-370-9752
Fax Number	:

Provider Business Practice Location Address
First Line	:	80 GARDEN CTR STE 156
Second Line	:
City	:	BROOMFIELD
State	:	CO
Zip	:	80020-1790
Country	:	US
Telephone Number	:	720-370-9752
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	LUCILLE RACHEL GOLDMAN HELLER
Credential	:	LPCC
Telephone Number	:	720-370-9752

Provider Enumeration Date	:	06/02/2026
Last Update Date	:	06/02/2026

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