| Lotus Center For Counseling Llc | |
|
1324 Lake Dr Se Ste 4 Grand Rapids MI 49506-1673 | |
| (616) 377-4555 | |
| Not Available |
| Full Name | Lotus Center For Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 1324 Lake Dr Se Ste 4, Grand Rapids, Michigan |
| Authorized Official Name and Position | Abigail Smith (OWNER) |
| Authorized Official Contact | 6163346584 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Center For Counseling Llc 2254 Shawnee Dr Se Grand Rapids MI 49506-5335 Ph: (616) 334-6584 | Lotus Center For Counseling Llc 1324 Lake Dr Se Ste 4 Grand Rapids MI 49506-1673 Ph: (616) 377-4555 |
| NPI Number | 1780457192 |
|---|---|
| Provider Enumeration Date | 11/07/2023 |
| Last Update Date | 11/07/2023 |
| Certification Date | 11/07/2023 |
| Medicare PECOS PAC ID | 1254775489 |
|---|---|
| Medicare Enrollment ID | O20240215003352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780457192 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Abigail J Smith |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1538725320 PECOS PAC ID: 0941644181 Enrollment ID: I20240215003567 |
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