Provider Demographics
NPI:1922403757
Name:LOTUS BEHAVIORAL CONSULTING
Entity Type:Organization
Organization Name:LOTUS BEHAVIORAL CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DEBORAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:GRUBER
Authorized Official - Suffix:
Authorized Official - Credentials:MED, PHD
Authorized Official - Phone:917-670-4076
Mailing Address - Street 1:400 E52ND STREET
Mailing Address - Street 2:8B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022
Mailing Address - Country:US
Mailing Address - Phone:917-670-4076
Mailing Address - Fax:
Practice Address - Street 1:400 E52ND STREET
Practice Address - Street 2:8B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022
Practice Address - Country:US
Practice Address - Phone:917-670-4076
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-10-22
Last Update Date:2014-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY11210360103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty