Provider Demographics
NPI:1104534254
Name:WHOLE LOTUS THERAPY, PLLC
Entity type:Organization
Organization Name:WHOLE LOTUS THERAPY, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER/PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:S
Authorized Official - Last Name:ALLEN
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW, E-RYT
Authorized Official - Phone:630-823-1226
Mailing Address - Street 1:2100 MANCHESTER RD STE 1604
Mailing Address - Street 2:
Mailing Address - City:WHEATON
Mailing Address - State:IL
Mailing Address - Zip Code:60187-4787
Mailing Address - Country:US
Mailing Address - Phone:630-474-4318
Mailing Address - Fax:
Practice Address - Street 1:2100 MANCHESTER RD STE 1604
Practice Address - Street 2:
Practice Address - City:WHEATON
Practice Address - State:IL
Practice Address - Zip Code:60187-4787
Practice Address - Country:US
Practice Address - Phone:630-474-4318
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-11-08
Last Update Date:2022-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)