Provider Demographics
NPI:1508466749
Name:JOURNEY TO LOTUS
Entity Type:Organization
Organization Name:JOURNEY TO LOTUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:CHARLOTTE
Authorized Official - Middle Name:
Authorized Official - Last Name:ANDREWS
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:215-398-1070
Mailing Address - Street 1:5008 ERRINGER PL
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4118
Mailing Address - Country:US
Mailing Address - Phone:215-398-1070
Mailing Address - Fax:
Practice Address - Street 1:6703 GERMANTOWN AVE STE 210-6
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19119-2109
Practice Address - Country:US
Practice Address - Phone:215-398-1070
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-27
Last Update Date:2020-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty