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General NPI Number Information
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NPI Number | 1184427866
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Entity Type | Organization
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Legal Business Name | LOTUS HAVEN WELLNESS LCSW PLLC
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 109 S WILLIAM ST FL 1
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City | NEWBURGH
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State | NY
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Zip | 12550-5949
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Country | US
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Telephone | 845-945-1693
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Fax |
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Provider Business Mailing Address
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Address Line | 109 S WILLIAM ST FL 1
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City | NEWBURGH
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State | NY
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Zip | 12550-5949
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Country | US
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Telephone | 845-945-1693
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Fax |
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Authorized Official
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Title or Position | OWNER/CLINICAL SOCIAL WORKER
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Name | ANAMARCELA MALDONADO
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Credential | LCSW
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Telephone | 845-945-1693
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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