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General NPI Number Information
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NPI Number | 1285077826
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Entity Type | Organization
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Legal Business Name | BLUE LOTUS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 04/14/2013
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Last Update Date | 04/14/2013
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Provider Practice Location Address
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Address Line | 8285 W ARBY AVE SUITE 225
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City | LAS VEGAS
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State | NV
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Zip | 89113-2235
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Country | US
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Telephone | 702-236-4181
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Fax |
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Provider Business Mailing Address
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Address Line | 6549 BAROQUE AVE
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City | LAS VEGAS
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State | NV
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Zip | 89139-6737
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Country | US
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Telephone | 702-236-4181
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | SANDRA M MOREL
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Credential | LMFT, LADC
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Telephone | 702-236-4181
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 1494
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 01209
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License Number State | NV
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