Provider Demographics
NPI:1063275733
Name:WHITE LOTUS COUNSELING CENTER LLC
Entity type:Organization
Organization Name:WHITE LOTUS COUNSELING CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:812-202-7177
Mailing Address - Street 1:127 W 5TH ST UPPR
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45331-1410
Mailing Address - Country:US
Mailing Address - Phone:812-202-7177
Mailing Address - Fax:855-930-4051
Practice Address - Street 1:127 W 5TH ST UPPR
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:OH
Practice Address - Zip Code:45331-1410
Practice Address - Country:US
Practice Address - Phone:812-202-7177
Practice Address - Fax:855-930-4051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-05
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty