Provider Demographics
NPI:1336842996
Name:LOTUS MIND THERAPY LLC
Entity Type:Organization
Organization Name:LOTUS MIND THERAPY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:HOLLAND-PITTS
Authorized Official - Suffix:
Authorized Official - Credentials:MS, LPC-S
Authorized Official - Phone:405-669-1989
Mailing Address - Street 1:801 QUAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:OK
Mailing Address - Zip Code:73065-5822
Mailing Address - Country:US
Mailing Address - Phone:405-669-1989
Mailing Address - Fax:405-669-3120
Practice Address - Street 1:8524 S WESTERN AVE STE 107
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73139-9247
Practice Address - Country:US
Practice Address - Phone:405-450-7815
Practice Address - Fax:405-294-1166
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-23
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty