Provider Demographics
NPI:1205537784
Name:LOTUS FLOWER COUNSELING LLC
Entity type:Organization
Organization Name:LOTUS FLOWER COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:PATRICIA
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ BURR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, LPCC, NCC
Authorized Official - Phone:505-463-0472
Mailing Address - Street 1:6666 4TH ST NW STE C-1
Mailing Address - Street 2:
Mailing Address - City:LOS RANCHOS
Mailing Address - State:NM
Mailing Address - Zip Code:87107-6144
Mailing Address - Country:US
Mailing Address - Phone:505-463-0472
Mailing Address - Fax:505-312-7646
Practice Address - Street 1:6666 4TH ST NW STE C-1
Practice Address - Street 2:
Practice Address - City:LOS RANCHOS
Practice Address - State:NM
Practice Address - Zip Code:87107-6144
Practice Address - Country:US
Practice Address - Phone:505-463-0472
Practice Address - Fax:505-312-7646
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-03-13
Last Update Date:2023-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)