Healthcare Provider Details

I. General information

NPI: 1750194841
Provider Name (Legal Business Name): LOTUS COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2025
Last Update Date: 01/31/2025
Certification Date: 01/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 VISTA CENTRE DR STE 18
FOREST VA
24551-2785
US

IV. Provider business mailing address

107 LAMONT CIR
MADISON HTS VA
24572-4558
US

V. Phone/Fax

Practice location:
  • Phone: 434-316-9339
  • Fax:
Mailing address:
  • Phone: 434-420-4777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State

VIII. Authorized Official

Name: AMANDA ROSE JOHNSTON
Title or Position: OWNER
Credential: LPC
Phone: 434-515-0508