Healthcare Provider Details

I. General information

NPI: 1538828165
Provider Name (Legal Business Name): LAVENDER HEALING CENTER, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2021
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1237 SOUTHRIDGE CT STE 103
HURST TX
76053-4393
US

IV. Provider business mailing address

8101 BOAT CLUB RD STE 240
FORT WORTH TX
76179-3631
US

V. Phone/Fax

Practice location:
  • Phone: 817-228-4792
  • Fax: 228-333-0127
Mailing address:
  • Phone:
  • Fax: 228-333-0119

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code261QM0801X
TaxonomyMental Health Clinic/Center (Including Community Mental Health Center)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MRS. KASEY SCHARNETT KING
Title or Position: PSYCHOTHERAPIST
Credential: LMFT-S
Phone: 817-228-4792