Healthcare Provider Details

I. General information

NPI: 1891501250
Provider Name (Legal Business Name): THE LOTUS CENTER FOR NEURODIVERSITY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/10/2024
Last Update Date: 08/07/2025
Certification Date: 08/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2609 HIGHWAY 101 N STE 201202
SEASIDE OR
97138-4344
US

IV. Provider business mailing address

80145 POLO RIDGE RD
WARRENTON OR
97146-9013
US

V. Phone/Fax

Practice location:
  • Phone: 971-286-8275
  • Fax: 503-861-8249
Mailing address:
  • Phone: 503-730-8589
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMBER BOWMAN
Title or Position: OWNER/PROFESSIONAL COUNSELOR ASSOC
Credential: PCA, ACAS
Phone: 503-470-1743