Provider Demographics
NPI:1083218309
Name:LOTUS THERAPY INC.
Entity Type:Organization
Organization Name:LOTUS THERAPY INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REHNA
Authorized Official - Middle Name:SUZANNE
Authorized Official - Last Name:BECKER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:630-414-8647
Mailing Address - Street 1:116 LEWIS LN
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60189-7420
Mailing Address - Country:US
Mailing Address - Phone:630-886-2638
Mailing Address - Fax:
Practice Address - Street 1:210 S 5TH ST STE 12
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:IL
Practice Address - Zip Code:60174-2700
Practice Address - Country:US
Practice Address - Phone:630-886-2638
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-27
Last Update Date:2022-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty