Provider Demographics
NPI:1467234906
Name:SACRED LOTUS JOURNEY, LLC
Entity Type:Organization
Organization Name:SACRED LOTUS JOURNEY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER AND CLINICAL THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DENISSA
Authorized Official - Middle Name:D
Authorized Official - Last Name:ROGERS- GILES
Authorized Official - Suffix:
Authorized Official - Credentials:TEMP-LPC-MHSP
Authorized Official - Phone:615-499-6137
Mailing Address - Street 1:501 UNION ST STE 553
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37219-1885
Mailing Address - Country:US
Mailing Address - Phone:615-499-6137
Mailing Address - Fax:
Practice Address - Street 1:501 UNION ST STE 553
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37219-1885
Practice Address - Country:US
Practice Address - Phone:615-499-6137
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Multi-Specialty
No171000000XOther Service ProvidersMilitary Health Care ProviderGroup - Multi-Specialty
No171400000XOther Service ProvidersHealth & Wellness CoachGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Multi-Specialty