MEDICARE: GROUNDED HEART THERAPY LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker

General Provider Information

NPI Number	:	1275461436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GROUNDED HEART THERAPY LLC

Provider Business Mailing Address
First Line	:	1405 4TH ST
Second Line	:
City	:	COLUMBIA CITY
State	:	OR
Zip	:	97018-9105
Country	:	US
Telephone Number	:	503-369-6585
Fax Number	:

Provider Business Practice Location Address
First Line	:	1405 4TH ST
Second Line	:
City	:	COLUMBIA CITY
State	:	OR
Zip	:	97018-9105
Country	:	US
Telephone Number	:	503-369-6585
Fax Number	:

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	DAWN RENE LOTTI
Credential	:	LCSW
Telephone Number	:	503-369-6585

Provider Enumeration Date	:	05/09/2026
Last Update Date	:	05/09/2026

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Directions to “GROUNDED HEART THERAPY LLC ” Practice Location

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