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General NPI Number Information
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NPI Number | 1972077527
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Entity Type | Organization
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Legal Business Name | LOTUS COUNSELING, LLC
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Dates
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Enumeration Date | 01/16/2019
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 32 S MAIN ST
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City | JANESVILLE
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State | WI
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Zip | 53545-3941
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Country | US
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Telephone | 608-618-5560
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Fax | 855-277-9589
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Provider Business Mailing Address
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Address Line | 32 S MAIN ST
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City | JANESVILLE
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State | WI
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Zip | 53545-3941
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Country | US
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Telephone | 608-618-5560
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Fax | 855-277-9589
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Authorized Official
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Title or Position | OWNER/THERAPIST
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Name | KRYSTAL A CONKLE
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Credential | MSW, LCSW
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Telephone | 608-618-5560
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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 |
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License Number State |
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