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General NPI Number Information
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NPI Number | 1932627668
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Entity Type | Organization
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Legal Business Name | LOTUS MENTAL HEALTH SERVICES LLC
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Dates
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Enumeration Date | 09/01/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 422 MAIN ST STE 203
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City | RACINE
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State | WI
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Zip | 53403-1031
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Country | US
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Telephone | 262-939-0701
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Fax |
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Provider Business Mailing Address
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Address Line | 422 MAIN ST STE 203
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City | RACINE
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State | WI
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Zip | 53403-1031
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Country | US
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Telephone | 262-939-0701
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Fax |
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Authorized Official
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Title or Position | OWNER/PSYCHOTHERAPIST
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Name | MS. DONNA IRENE ZEWEN-ROSSMANN
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Credential | MSW, APSW
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Telephone | 262-939-0701
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 129914-121
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License Number State | WI
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