Provider Demographics
NPI:1457941288
Name:LOTUS COUNSELING
Entity Type:Organization
Organization Name:LOTUS COUNSELING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:
Authorized Official - Last Name:VALLEJO
Authorized Official - Suffix:
Authorized Official - Credentials:LADC
Authorized Official - Phone:308-672-6587
Mailing Address - Street 1:615 S BELTLINE HWY W STE 2
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBLUFF
Mailing Address - State:NE
Mailing Address - Zip Code:69361-1318
Mailing Address - Country:US
Mailing Address - Phone:308-672-6587
Mailing Address - Fax:
Practice Address - Street 1:615 S BELTLINE HWY W STE 2
Practice Address - Street 2:
Practice Address - City:SCOTTSBLUFF
Practice Address - State:NE
Practice Address - Zip Code:69361-1318
Practice Address - Country:US
Practice Address - Phone:308-672-6587
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-25
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Single Specialty