Provider Demographics
NPI:1215818059
Name:INNER LOTUS LLC
Entity type:Organization
Organization Name:INNER LOTUS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:BEAVIS
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW CLINICAL
Authorized Official - Phone:248-602-3303
Mailing Address - Street 1:40600 ANN ARBOR ROAD EAST
Mailing Address - Street 2:STE 200
Mailing Address - City:PLYMOUTH
Mailing Address - State:MI
Mailing Address - Zip Code:48170
Mailing Address - Country:US
Mailing Address - Phone:248-602-3303
Mailing Address - Fax:248-602-3303
Practice Address - Street 1:40600 ANN ARBOR RD E STE 200
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MI
Practice Address - Zip Code:48170-4675
Practice Address - Country:US
Practice Address - Phone:248-602-3303
Practice Address - Fax:248-602-3303
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-09
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty