| Blossoming Lotus Therapy Lcsw Pllc | |
|
145 Sunrise Hwy Ste 7 Lindenhurst NY 11757-2500 | |
| (516) 254-9201 | |
| Not Available |
| Full Name | Blossoming Lotus Therapy Lcsw Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 145 Sunrise Hwy Ste 7, Lindenhurst, New York |
| Authorized Official Name and Position | Jessica M Hardial (CEO) |
| Authorized Official Contact | 5162549201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossoming Lotus Therapy Lcsw Pllc 145 Sunrise Hwy Ste 7 Lindenhurst NY 11757-2500 Ph: (516) 254-9201 | Blossoming Lotus Therapy Lcsw Pllc 145 Sunrise Hwy Ste 7 Lindenhurst NY 11757-2500 Ph: (516) 254-9201 |
| NPI Number | 1720754245 |
|---|---|
| Provider Enumeration Date | 08/17/2021 |
| Last Update Date | 03/28/2023 |
| Certification Date | 03/28/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720754245 | NPI | - | NPPES |
| 1366893240 | Other | NY | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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