MEDICARE: LOTUS MENTAL HEALTH PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP0808X	Psychiatric/Mental Health Nurse Practitioner

General Provider Information

NPI Number	:	1386459436
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS MENTAL HEALTH PLLC

Provider Business Mailing Address
First Line	:	8307 UNIVERSITY EXEC PARK DR STE 242
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1374
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	8307 UNIVERSITY EXEC PARK DR STE 242
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28262-1374
Country	:	US
Telephone Number	:	980-478-9661
Fax Number	:	980-500-1475

Authorized Official
Title or Position	:	PMHNP
Name	:	PAYAL PATEL
Credential	:
Telephone Number	:	609-350-4095

Provider Enumeration Date	:	02/07/2025
Last Update Date	:	02/07/2025

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