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General NPI Number Information
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NPI Number | 1992177752
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Entity Type | Organization
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Legal Business Name | RED LOTUS COUNSELING
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Dates
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Enumeration Date | 10/20/2015
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Last Update Date | 10/20/2015
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Provider Practice Location Address
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Address Line | 2441 MARES RD SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87105-4143
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Country | US
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Telephone | 505-203-5473
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Fax |
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Provider Business Mailing Address
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Address Line | 2441 MARES RD SW
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City | ALBUQUERQUE
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State | NM
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Zip | 87105-4143
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Country | US
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Telephone | 505-203-5473
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | CATHERINE HARRIS
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Credential | LCSW
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Telephone | 505-203-5473
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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 | C-07238
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License Number State | NM
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