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General NPI Number Information
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NPI Number | 1790581643
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Entity Type | Organization
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Legal Business Name | LOTUS MOON COUNSELING
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Dates
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Enumeration Date | 02/21/2025
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 18756 STONE OAK PKWY SUITE 200
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City | SAN ANTONIO
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State | TX
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Zip | 78258
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Country | US
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Telephone | 210-913-5432
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Fax |
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Provider Business Mailing Address
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Address Line | 31004 PRETA WAY
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City | BULVERDE
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State | TX
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Zip | 78163-2349
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Country | US
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Telephone | 662-425-8469
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHARON LOVERNE GREGORY
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Credential | LPC
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Telephone | 210-913-5432
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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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