| Lotus Counseling Inc | |
|
1409 Willow St Ste 109 Minneapolis MN 55403-2241 | |
| (612) 405-9395 | |
| Not Available |
| Full Name | Lotus Counseling Inc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 1409 Willow St Ste 109, Minneapolis, Minnesota |
| Authorized Official Name and Position | Kathryn Gandolph (PRESIDENT) |
| Authorized Official Contact | 6122074103 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Counseling Inc 3309 Library Ln St Louis Park MN 55426-4210 Ph: (612) 207-4103 | Lotus Counseling Inc 1409 Willow St Ste 109 Minneapolis MN 55403-2241 Ph: (612) 405-9395 |
| NPI Number | 1215581335 |
|---|---|
| Provider Enumeration Date | 07/26/2019 |
| Last Update Date | 07/26/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215581335 | NPI | - | NPPES |
| 1891060562 | Medicaid | MN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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