Provider Demographics
NPI:1861279093
Name:NEON LAVENDER THERAPY AND WELLNESS LLC
Entity type:Organization
Organization Name:NEON LAVENDER THERAPY AND WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BETH
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:LOHMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:317-496-0671
Mailing Address - Street 1:5250 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46228-2302
Mailing Address - Country:US
Mailing Address - Phone:260-786-6674
Mailing Address - Fax:
Practice Address - Street 1:9135 N MERIDIAN ST STE A9
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-1815
Practice Address - Country:US
Practice Address - Phone:260-786-6674
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)