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General NPI Number Information
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NPI Number | 1245698224
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Entity Type | Organization
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Legal Business Name | LOTUS CIRCLE COUNSELING SERVICES
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Dates
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Enumeration Date | 02/04/2016
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Last Update Date | 02/04/2016
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Provider Practice Location Address
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Address Line | 10221 SLATER AVE STE 205
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-4744
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Country | US
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Telephone | 714-623-7716
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Fax | 562-261-5832
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Provider Business Mailing Address
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Address Line | PO BOX 8364
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92728-8364
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | MS. IRENE Y LU
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Credential | LMFT
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Telephone | 714-623-7716
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | LMFT86374
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License Number State | CA
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