| Lotus Psychotherapy & Consultation Services Llc | |
|
3307 W 96th St Indianapolis IN 46268-1106 | |
| (317) 500-3643 | |
| Not Available |
| Full Name | Lotus Psychotherapy & Consultation Services Llc |
|---|---|
| Speciality | Social Worker |
| Location | 3307 W 96th St, Indianapolis, Indiana |
| Authorized Official Name and Position | Neva E Hagedorn (OWNER) |
| Authorized Official Contact | 3175003643 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Psychotherapy & Consultation Services Llc Po Box 19105 Indianapolis IN 46219-0105 Ph: (317) 500-3643 | Lotus Psychotherapy & Consultation Services Llc 3307 W 96th St Indianapolis IN 46268-1106 Ph: (317) 500-3643 |
| NPI Number | 1831799014 |
|---|---|
| Provider Enumeration Date | 10/28/2020 |
| Last Update Date | 10/28/2020 |
| Certification Date | 10/28/2020 |
| Medicare PECOS PAC ID | 0941611461 |
|---|---|
| Medicare Enrollment ID | O20201204000312 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831799014 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Neva E Hagedorn |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013226729 PECOS PAC ID: 8729242110 Enrollment ID: I20120615000025 |
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