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General NPI Number Information
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NPI Number | 1205537784
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Entity Type | Organization
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Legal Business Name | LOTUS FLOWER COUNSELING LLC
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Dates
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Enumeration Date | 03/13/2023
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Last Update Date | 03/13/2023
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Provider Practice Location Address
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Address Line | 6666 4TH ST NW STE C-1
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City | LOS RANCHOS
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State | NM
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Zip | 87107-6144
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Country | US
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Telephone | 505-463-0472
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Fax | 505-312-7646
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Provider Business Mailing Address
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Address Line | 6666 4TH ST NW STE C-1
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City | LOS RANCHOS
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State | NM
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Zip | 87107-6144
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Country | US
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Telephone | 505-463-0472
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Fax | 505-312-7646
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Authorized Official
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Title or Position | OWNER/CLINICAL DIRECTOR
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Name | PATRICIA MARTINEZ BURR
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Credential | PHD, LPCC, NCC
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Telephone | 505-463-0472
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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