Provider Demographics
NPI:1851289565
Name:BLUE LOTUS FAMILY THERAPY
Entity type:Organization
Organization Name:BLUE LOTUS FAMILY THERAPY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGE AND FAMILY THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:LAUTEASHA
Authorized Official - Middle Name:
Authorized Official - Last Name:LANCASTER
Authorized Official - Suffix:
Authorized Official - Credentials:MASTERS
Authorized Official - Phone:770-609-9844
Mailing Address - Street 1:11585 JONES BRIDGE RD, STE 420 UNIT # 176
Mailing Address - Street 2:
Mailing Address - City:JOHNS CREEK, GA
Mailing Address - State:GA
Mailing Address - Zip Code:30022
Mailing Address - Country:US
Mailing Address - Phone:770-609-9844
Mailing Address - Fax:
Practice Address - Street 1:410 PEACH TREE PARKWAY SUITE 425
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30041
Practice Address - Country:US
Practice Address - Phone:770-609-9844
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health