Provider Demographics
NPI:1952838005
Name:LOTUS PSYCHOTHERAPY, LLC
Entity Type:Organization
Organization Name:LOTUS PSYCHOTHERAPY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ELIZABETH
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLASPIE
Authorized Official - Suffix:
Authorized Official - Credentials:LIMHP, LCSW
Authorized Official - Phone:402-885-9855
Mailing Address - Street 1:5649 EMILE ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-1217
Mailing Address - Country:US
Mailing Address - Phone:402-960-0355
Mailing Address - Fax:
Practice Address - Street 1:17670 WELCH PLZ STE 102
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68135-3805
Practice Address - Country:US
Practice Address - Phone:402-885-9855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-05-20
Last Update Date:2017-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE17601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty