=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407467186
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | JOYFUL LOTUS COUNSELING, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/14/2020
-----------------------------------------------------
Last Update Date | 04/08/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2202 E 49TH ST STE 400
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74105-8714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-297-8822
-----------------------------------------------------
Fax | 918-471-2848
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2202 E 49TH ST STE 400
-----------------------------------------------------
City | TULSA
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74105-8714
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-297-8822
-----------------------------------------------------
Fax | 918-471-2848
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | THERAPIST/OWNER
-----------------------------------------------------
Name | ASHLEY GABRIEL
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 918-639-8654
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------