Healthcare Provider Details

I. General information

NPI: 1265358832
Provider Name (Legal Business Name): RISING LOTUS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3076 MOON LAKE DR
WEST BLOOMFIELD MI
48323-1842
US

IV. Provider business mailing address

3076 MOON LAKE DR
WEST BLOOMFIELD MI
48323-1842
US

V. Phone/Fax

Practice location:
  • Phone: 248-266-2840
  • Fax:
Mailing address:
  • Phone: 248-266-2840
  • Fax:

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: CASSAUNDRA VAUGHN
Title or Position: OWNER
Credential: LPC
Phone: 248-266-2840