Healthcare Provider Details

I. General information

NPI: 1184589038
Provider Name (Legal Business Name): LOTUS ASCENT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2025
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2512 E 14TH ST UNIT A
CLOVIS NM
88101-8059
US

IV. Provider business mailing address

114 ELM ST
HEREFORD TX
79045-4024
US

V. Phone/Fax

Practice location:
  • Phone: 575-530-0359
  • Fax:
Mailing address:
  • Phone: 806-808-6292
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: AMY MARTINEZ
Title or Position: OWNER
Credential: LCSW
Phone: 806-808-6292