Provider Demographics
NPI:1275301293
Name:LOTUS HEALING COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:LOTUS HEALING COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DIAMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:KINERMON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:131-228-6557
Mailing Address - Street 1:2327 PENTLAND DR
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35235-2060
Mailing Address - Country:US
Mailing Address - Phone:205-730-6840
Mailing Address - Fax:
Practice Address - Street 1:200 CENTURY PARK S STE 116
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35226-3923
Practice Address - Country:US
Practice Address - Phone:205-730-6840
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-19
Last Update Date:2023-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty