| Lotus Theory Llc | |
|
434 Mamaroneck Ave Ste 104 Mamaroneck NY 10543-2698 | |
| (917) 594-2497 | |
| Not Available |
| Full Name | Lotus Theory Llc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 434 Mamaroneck Ave Ste 104, Mamaroneck, New York |
| Authorized Official Name and Position | Justine Astacio (FOUNDER) |
| Authorized Official Contact | 9175942497 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Theory Llc 434 Mamaroneck Ave Ste 104 Mamaroneck NY 10543-2698 Ph: (917) 594-2497 | Lotus Theory Llc 434 Mamaroneck Ave Ste 104 Mamaroneck NY 10543-2698 Ph: (917) 594-2497 |
| NPI Number | 1518671734 |
|---|---|
| Provider Enumeration Date | 01/11/2023 |
| Last Update Date | 01/11/2023 |
| Certification Date | 01/11/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1518671734 | NPI | - | NPPES |
| 1942772322 | Other | NY | N/A |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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