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General NPI Number Information
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NPI Number | 1114577582
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Entity Type | Organization
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Legal Business Name | INSPIRING LOTUS HEALING SANCTUARY
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Dates
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Enumeration Date | 09/17/2019
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Last Update Date | 05/13/2020
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Provider Practice Location Address
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Address Line | 923 FIRST COLONIAL RD STE 1817
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City | VIRGINIA BEACH
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State | VA
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Zip | 23454-3182
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Country | US
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Telephone | 315-591-6605
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Fax | 757-512-5714
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Provider Business Mailing Address
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Address Line | 4001 COUNTY ST
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City | PORTSMOUTH
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State | VA
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Zip | 23707-2903
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Country | US
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Telephone | 315-591-6605
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | MISS JENNIFER LYNN KINZIE
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Credential | MS, LPC, LMHC
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Telephone | 315-591-6605
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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