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General NPI Number Information
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NPI Number | 1972911980
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Entity Type | Organization
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Legal Business Name | LOTUSOAK COUNSELING, LLC
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Dates
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Enumeration Date | 07/23/2014
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Last Update Date | 07/23/2014
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Provider Practice Location Address
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Address Line | 2388 S BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80223-4313
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Country | US
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Telephone | 303-870-0743
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Fax |
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Provider Business Mailing Address
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Address Line | 2388 S BANNOCK ST
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City | DENVER
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State | CO
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Zip | 80223-4313
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | THERAPIST
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Name | DR. SHAWNA MARIE MARGESSON
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Credential | PH.D.
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Telephone | 303-870-0743
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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 | NLC. 0103518
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License Number State | CO
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