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General NPI Number Information
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NPI Number | 1598530305
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Entity Type | Organization
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Legal Business Name | PEACEFUL LOTUS THERAPY, LLC
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Dates
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Enumeration Date | 11/21/2023
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Last Update Date | 06/18/2025
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Provider Practice Location Address
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Address Line | 3001 W BELTLINE HWY STE 402
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City | MADISON
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State | WI
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Zip | 53713-2832
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Country | US
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Telephone | 608-440-9004
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 153
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City | OREGON
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State | WI
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Zip | 53575-0153
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Country | US
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Telephone | 608-440-9004
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. LACEY N SCHMIDT
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Credential | PSY.D.
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Telephone | 608-440-9004
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number |
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License Number State |
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