Provider Demographics
NPI:1811599475
Name:LOTUS WISDOM COUNSELING SERVICES, PLLC
Entity Type:Organization
Organization Name:LOTUS WISDOM COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:NICHOLE
Authorized Official - Last Name:BODWELL
Authorized Official - Suffix:
Authorized Official - Credentials:LCMHC
Authorized Official - Phone:336-892-9061
Mailing Address - Street 1:138 S CHERRY ST STE 400
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27101-5271
Mailing Address - Country:US
Mailing Address - Phone:336-892-9061
Mailing Address - Fax:336-899-0170
Practice Address - Street 1:138 S CHERRY ST STE 400
Practice Address - Street 2:
Practice Address - City:WINSTON SALEM
Practice Address - State:NC
Practice Address - Zip Code:27101-5271
Practice Address - Country:US
Practice Address - Phone:336-892-9061
Practice Address - Fax:336-899-0170
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-09
Last Update Date:2021-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselorGroup - Single Specialty
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)Group - Single Specialty