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General NPI Number Information
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NPI Number | 1558905869
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Entity Type | Organization
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Legal Business Name | LOTUS COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 10/30/2019
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Last Update Date | 10/30/2019
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Provider Practice Location Address
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Address Line | 1401 GREENWAY CT OFC 2A
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City | SANFORD
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State | NC
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Zip | 27330-6954
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Country | US
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Telephone | 919-935-2925
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 GREENWAY CT OFC 2A
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City | SANFORD
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State | NC
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Zip | 27330-6954
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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 | OUTPATIENT THERAPIST
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Name | CYNTHIA WOOLEY HICKMAN
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Credential | LPC
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Telephone | 919-935-2925
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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