Provider Demographics
NPI:1184427866
Name:LOTUS HAVEN WELLNESS LCSW PLLC
Entity type:Organization
Organization Name:LOTUS HAVEN WELLNESS LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL SOCIAL WORKER
Authorized Official - Prefix:
Authorized Official - First Name:ANAMARCELA
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:845-945-1693
Mailing Address - Street 1:109 S WILLIAM ST FL 1
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-5949
Mailing Address - Country:US
Mailing Address - Phone:845-945-1693
Mailing Address - Fax:
Practice Address - Street 1:109 S WILLIAM ST FL 1
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-5949
Practice Address - Country:US
Practice Address - Phone:845-945-1693
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-28
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty