Light & Lotus Wellness Pllc | |
202 6th St Ste 301e Castle Rock CO 80104-1731 | |
(720) 515-4710 | |
Not Available |
Full Name | Light & Lotus Wellness Pllc |
---|---|
Speciality | Social Worker |
Location | 202 6th St Ste 301e, Castle Rock, Colorado |
Authorized Official Name and Position | Stacey Hostetter (OWNER) |
Authorized Official Contact | 7205154710 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
Light & Lotus Wellness Pllc 202 6th St Ste 301e Castle Rock CO 80104-1731 Ph: (720) 515-4710 | Light & Lotus Wellness Pllc 202 6th St Ste 301e Castle Rock CO 80104-1731 Ph: (720) 515-4710 |
NPI Number | 1598531204 |
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Provider Enumeration Date | 12/04/2023 |
Last Update Date | 12/04/2023 |
Certification Date | 12/04/2023 |
Medicare PECOS PAC ID | 8820448558 |
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Medicare Enrollment ID | O20231221001211 |
Identifier | Type | State | Issuer |
---|---|---|---|
1598531204 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
Provider Name | Stacey A Hostetter |
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Provider Type | Practitioner - Clinical Social Worker |
Provider Identifiers | NPI Number: 1558766584 PECOS PAC ID: 6608148283 Enrollment ID: I20170816002542 |
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