Provider Demographics
NPI:1770370637
Name:LOTUS COUNSELING OF SD
Entity type:Organization
Organization Name:LOTUS COUNSELING OF SD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNA
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:KVAALE
Authorized Official - Suffix:
Authorized Official - Credentials:LPC-MH
Authorized Official - Phone:612-201-7860
Mailing Address - Street 1:1601 E 69TH ST STE 201A
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57108-8321
Mailing Address - Country:US
Mailing Address - Phone:612-201-7860
Mailing Address - Fax:605-309-7909
Practice Address - Street 1:1601 E 69TH ST STE 201A
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57108-8321
Practice Address - Country:US
Practice Address - Phone:612-201-7860
Practice Address - Fax:605-309-7909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty