Healthcare Provider Details

I. General information

NPI: 1730891110
Provider Name (Legal Business Name): LOTUS GROUP WELLNESS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2022
Last Update Date: 09/21/2023
Certification Date: 09/21/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14311 SETTLE DR
RIXEYVILLE VA
22737-1918
US

IV. Provider business mailing address

14311 SETTLE DR
RIXEYVILLE VA
22737-1918
US

V. Phone/Fax

Practice location:
  • Phone: 207-798-0899
  • Fax:
Mailing address:
  • Phone: 207-798-0899
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number
License Number State

VIII. Authorized Official

Name: DR. THOMAS VINCENT PARINELLO
Title or Position: OWNER/CLINICAL PSYCHOLOGIST
Credential: PHD
Phone: 207-798-0899