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General NPI Number Information
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NPI Number | 1568273225
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Entity Type | Organization
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Legal Business Name | LOTUS BEHAVIORAL HEALTH SERVICES
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Dates
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Enumeration Date | 01/14/2025
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Last Update Date | 04/22/2025
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Provider Practice Location Address
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Address Line | 3710 SHANNON RD UNIT 51096
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City | DURHAM
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State | NC
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Zip | 27717-0704
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Country | US
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Telephone | 404-692-0232
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Fax |
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Provider Business Mailing Address
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Address Line | 3710 SHANNON RD UNIT 51096
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City | DURHAM
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State | NC
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Zip | 27717-0704
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Country | US
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Telephone | 404-692-0232
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOVON CALDWELL
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Credential |
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Telephone | 404-692-0232
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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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Taxonomy #2
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number |
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License Number State |
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