Healthcare Provider Details

I. General information

NPI: 1801467519
Provider Name (Legal Business Name): THE LOTUS CONNECTION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2021
Last Update Date: 01/23/2026
Certification Date: 01/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5995 OREN AVE N STE 108
STILLWATER MN
55082-5302
US

IV. Provider business mailing address

5995 OREN AVE N STE 108
STILLWATER MN
55082-5302
US

V. Phone/Fax

Practice location:
  • Phone: 612-524-9237
  • Fax: 612-314-8317
Mailing address:
  • Phone: 612-524-9237
  • Fax: 612-314-8317

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number
License Number State

VIII. Authorized Official

Name: SHANTE HANSON
Title or Position: OWNER
Credential: LMFT
Phone: 612-524-9237