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General NPI Number Information
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NPI Number | 1952787657
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Entity Type | Organization
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Legal Business Name | LOTUS WELLNESS LLC
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Dates
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Enumeration Date | 08/04/2015
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Last Update Date | 06/14/2018
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Provider Practice Location Address
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Address Line | 910 CEDAR ST
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City | HONOLULU
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State | HI
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Zip | 96814-2329
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Country | US
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Telephone | 808-255-8836
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Fax |
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Provider Business Mailing Address
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Address Line | 815 ALAKEA STREET
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City | HONOLULU
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State | HI
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Zip | 96813
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Country | US
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Telephone | 808-255-8836
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KA YUNG KAREN CHAN
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Credential | LCSW
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Telephone | 808-255-8836
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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 | LCSW 4051
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License Number State | HI
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