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General NPI Number Information
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NPI Number | 1508466749
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Entity Type | Organization
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Legal Business Name | JOURNEY TO LOTUS
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Dates
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Enumeration Date | 10/27/2020
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Last Update Date | 10/27/2020
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Provider Practice Location Address
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Address Line | 6703 GERMANTOWN AVE STE 210-6
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City | PHILADELPHIA
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State | PA
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Zip | 19119-2109
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Country | US
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Telephone | 215-398-1070
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Fax |
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Provider Business Mailing Address
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Address Line | 5008 ERRINGER PL
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City | PHILADELPHIA
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State | PA
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Zip | 19144-4118
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Country | US
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Telephone | 215-398-1070
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CHARLOTTE ANDREWS
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Credential | LPC
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Telephone | 215-398-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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