MEDICARE: LAVENDER SKY THERAPY

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	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1073455606
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LAVENDER SKY THERAPY

Provider Business Mailing Address
First Line	:	2000 HAYES DR
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-4920
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 POYNTZ AVE STE 273
Second Line	:
City	:	MANHATTAN
State	:	KS
Zip	:	66502-8039
Country	:	US
Telephone Number	:	785-655-8792
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MEGAN WANAMAKER
Credential	:	LSCSW
Telephone Number	:	785-655-8762

Provider Enumeration Date	:	04/06/2026
Last Update Date	:	04/06/2026

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Directions to “LAVENDER SKY THERAPY ” Practice Location

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