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General NPI Number Information
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NPI Number | 1710427513
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Entity Type | Organization
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Legal Business Name | LOTUS COUNSELING SERVICES, LLC
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Dates
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Enumeration Date | 02/28/2017
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Last Update Date | 09/24/2024
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Provider Practice Location Address
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Address Line | 2006 BLAINE ST
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City | CALDWELL
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State | ID
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Zip | 83605-4343
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Country | US
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Telephone | 208-454-3430
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Fax | 888-972-1962
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Provider Business Mailing Address
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Address Line | 2006 BLAINE ST
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City | CALDWELL
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State | ID
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Zip | 83605-4343
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Country | US
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Telephone | 208-454-3430
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Fax | 888-972-1962
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Authorized Official
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Title or Position | OWNER/PROVIDER
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Name | SARA L MCCLELLIN HELMER
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Credential | LCSW
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Telephone | 208-454-3430
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 35506
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License Number State | ID
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