| Lotus Blossom Counseling Llc | |
|
152 Northampton St Easthampton MA 01027-1020 | |
| (860) 539-2242 | |
| Not Available |
| Full Name | Lotus Blossom Counseling Llc |
|---|---|
| Speciality | Social Worker |
| Location | 152 Northampton St, Easthampton, Massachusetts |
| Authorized Official Name and Position | Tara M Haines (OWNER) |
| Authorized Official Contact | 8605392242 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Blossom Counseling Llc 15 Underwood Ave Easthampton MA 01027-1251 Ph: (860) 539-2242 | Lotus Blossom Counseling Llc 152 Northampton St Easthampton MA 01027-1020 Ph: (860) 539-2242 |
| NPI Number | 1528565454 |
|---|---|
| Provider Enumeration Date | 04/08/2018 |
| Last Update Date | 04/08/2018 |
| Medicare PECOS PAC ID | 6406182468 |
|---|---|
| Medicare Enrollment ID | O20190729002438 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528565454 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 118428 (Massachusetts) | Primary |
| Provider Name | Tara Martin Haines |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1780043190 PECOS PAC ID: 0749579050 Enrollment ID: I20160510000657 |
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