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General NPI Number Information
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NPI Number | 1851289565
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Entity Type | Organization
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Legal Business Name | BLUE LOTUS FAMILY THERAPY
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Dates
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Enumeration Date | 06/24/2025
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Last Update Date | 06/24/2025
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Provider Practice Location Address
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Address Line | 410 PEACH TREE PARKWAY SUITE 425
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City | CUMMING
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State | GA
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Zip | 30041
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Country | US
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Telephone | 770-609-9844
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Fax |
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Provider Business Mailing Address
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Address Line | 11585 JONES BRIDGE RD, STE 420 UNIT # 176
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City | JOHNS CREEK, GA
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State | GA
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Zip | 30022
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Country | US
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Telephone | 770-609-9844
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Fax |
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Authorized Official
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Title or Position | MARRIAGE AND FAMILY THERAPIST
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Name | LAUTEASHA LANCASTER
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Credential | MASTERS
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Telephone | 770-609-9844
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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