Healthcare Provider Details

I. General information

NPI: 1740028950
Provider Name (Legal Business Name): BLUE LOTUS COUNSELING AND WELLNESS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/20/2024
Last Update Date: 07/20/2024
Certification Date: 07/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 FOXGLOVE DR STE 6
MOUNT STERLING KY
40353-9770
US

IV. Provider business mailing address

250 FOXGLOVE DR STE 6
MOUNT STERLING KY
40353-9770
US

V. Phone/Fax

Practice location:
  • Phone: 859-743-4129
  • Fax: 859-251-0169
Mailing address:
  • Phone: 859-743-4129
  • Fax: 859-251-0169

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: LAURA NICOLE REED
Title or Position: DIRECTOR/OWNER
Credential: LPCC
Phone: 859-743-4129