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General NPI Number Information
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NPI Number | 1083593370
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Entity Type | Organization
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Legal Business Name | LAVENDER HOUSE PSYCHOLOGY, LLC
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 1177 N GRANT ST # 308
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City | DENVER
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State | CO
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Zip | 80203-2362
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Country | US
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Telephone | 720-772-9969
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Fax |
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Provider Business Mailing Address
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Address Line | 5626 HOMESIDE AVE
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City | LOS ANGELES
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State | CA
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Zip | 90016-3226
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LICENSED CLINICAL PSYCHOLOGIST
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Name | DR. KARMEN THULIN
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Credential | PSYD
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Telephone | 720-675-7050
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number |
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License Number State |
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