Provider Demographics
NPI:1932627668
Name:LOTUS MENTAL HEALTH SERVICES LLC
Entity Type:Organization
Organization Name:LOTUS MENTAL HEALTH SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:IRENE
Authorized Official - Last Name:ZEWEN-ROSSMANN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, APSW
Authorized Official - Phone:262-939-0701
Mailing Address - Street 1:422 MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:RACINE
Mailing Address - State:WI
Mailing Address - Zip Code:53403-1031
Mailing Address - Country:US
Mailing Address - Phone:262-939-0701
Mailing Address - Fax:
Practice Address - Street 1:422 MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:RACINE
Practice Address - State:WI
Practice Address - Zip Code:53403-1031
Practice Address - Country:US
Practice Address - Phone:262-939-0701
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-09-01
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI129914-121106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty