Provider Demographics
NPI:1659863967
Name:RISING LOTUS THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:RISING LOTUS THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:J
Authorized Official - Last Name:CHESSHIR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:501-318-8190
Mailing Address - Street 1:1401 MALVERN AVE STE 200A
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-6371
Mailing Address - Country:US
Mailing Address - Phone:501-318-8190
Mailing Address - Fax:844-799-3414
Practice Address - Street 1:1401 MALVERN AVE STE 200A
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-6371
Practice Address - Country:US
Practice Address - Phone:501-318-8190
Practice Address - Fax:844-799-3414
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-06-01
Last Update Date:2018-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR3521-C261QM0850X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health