Provider Demographics
NPI:1609453463
Name:LOTUS ADDICTION COUNSELING
Entity Type:Organization
Organization Name:LOTUS ADDICTION COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:SUE
Authorized Official - Last Name:WOOD
Authorized Official - Suffix:
Authorized Official - Credentials:IADC
Authorized Official - Phone:515-230-8541
Mailing Address - Street 1:208 5TH ST STE 150
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50010-6259
Mailing Address - Country:US
Mailing Address - Phone:515-230-8541
Mailing Address - Fax:515-232-5635
Practice Address - Street 1:208 5TH ST STE 150
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50010-6259
Practice Address - Country:US
Practice Address - Phone:515-230-8541
Practice Address - Fax:515-232-5635
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-26
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty