MEDICARE: LOTUS MENTAL HEALTH GROUP P.A. (DBA LOTUS PERINATAL)

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1982375739
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOTUS MENTAL HEALTH GROUP P.A. (DBA LOTUS PERINATAL)

Provider Business Mailing Address
First Line	:	1193 SE PORT ST LUCIE BLVD # 139
Second Line	:
City	:	PORT ST LUCIE
State	:	FL
Zip	:	34952-5332
Country	:	US
Telephone Number	:	561-205-6887
Fax Number	:	561-468-8410

Provider Business Practice Location Address
First Line	:	2263 LOMBARDY ST
Second Line	:
City	:	LONGMONT
State	:	CO
Zip	:	80503-4189
Country	:	US
Telephone Number	:	561-205-6887
Fax Number	:	561-468-8410

Authorized Official
Title or Position	:	LICENSED PSYCHOLOGIST
Name	:	DR. KATRINA CARRERA
Credential	:	PSY.D.
Telephone Number	:	561-205-6887

Provider Enumeration Date	:	09/22/2021
Last Update Date	:	04/08/2026

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