| Embodied Lotus Llc | |
|
2625 Redwing Rd Ste 370 Fort Collins CO 80526-6314 | |
| (970) 818-2004 | |
| Not Available |
| Full Name | Embodied Lotus Llc |
|---|---|
| Speciality | Community/Behavioral Health |
| Location | 2625 Redwing Rd Ste 370, Fort Collins, Colorado |
| Authorized Official Name and Position | Susanna Turner (OWNER/PSYCHOLOGIST) |
| Authorized Official Contact | 9708182004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Embodied Lotus Llc 217 Park St Fort Collins CO 80521-1825 Ph: () - | Embodied Lotus Llc 2625 Redwing Rd Ste 370 Fort Collins CO 80526-6314 Ph: (970) 818-2004 |
| NPI Number | 1609616457 |
|---|---|
| Provider Enumeration Date | 05/29/2024 |
| Last Update Date | 05/29/2024 |
| Certification Date | 05/29/2024 |
| Medicare PECOS PAC ID | 6002358702 |
|---|---|
| Medicare Enrollment ID | O20240610002749 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609616457 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
| Provider Name | Susanna Jane Turner |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1093481459 PECOS PAC ID: 7810439510 Enrollment ID: I20240610002883 |
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