MEDICARE: LOTUS COUNSELING AND FAMILY SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	225600000X	Dance Therapist
2	376J00000X	Homemaker
3	1041C0700X	Clinical Social Worker
4	106H00000X	Marriage & Family Therapist
5	106S00000X	Behavior Technician
6	221700000X	Art Therapist
7	104100000X	Social Worker

General Provider Information

NPI Number	:	1184334781
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS COUNSELING AND FAMILY SERVICES, LLC

Provider Business Mailing Address
First Line	:	5699 E 71ST ST STE 2A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3950
Country	:	US
Telephone Number	:	574-326-0989
Fax Number	:

Provider Business Practice Location Address
First Line	:	5699 E 71ST ST STE 2A
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-3950
Country	:	US
Telephone Number	:	574-326-0989
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MISS VANESSA IDONA
Credential	:	LCSW
Telephone Number	:	929-302-6163

Provider Enumeration Date	:	12/05/2022
Last Update Date	:	12/05/2022

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