| Lotus Integrative Behavioral Health Llc | |
|
1 East Merchants Drive Oswego IL 60543 | |
| (305) 518-6846 | |
| Not Available |
| Full Name | Lotus Integrative Behavioral Health Llc |
|---|---|
| Speciality | Social Worker |
| Location | 1 East Merchants Drive, Oswego, Illinois |
| Authorized Official Name and Position | Nicole M Mcdonald (OWNER) |
| Authorized Official Contact | 6305518684 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Integrative Behavioral Health Llc 1905 Marketview Dr Unit 256 Yorkville IL 60560-1896 Ph: (603) 551-8684 | Lotus Integrative Behavioral Health Llc 1 East Merchants Drive Oswego IL 60543 Ph: (305) 518-6846 |
| NPI Number | 1841893682 |
|---|---|
| Provider Enumeration Date | 11/16/2020 |
| Last Update Date | 01/11/2021 |
| Certification Date | 01/11/2021 |
| Medicare PECOS PAC ID | 5890109490 |
|---|---|
| Medicare Enrollment ID | O20210121002595 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1841893682 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Nicole M Mcdonald-martinez |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1396058830 PECOS PAC ID: 4284815267 Enrollment ID: I20110223001114 |
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