Provider Demographics
NPI:1265304562
Name:LIVING LOTUS
Entity type:Organization
Organization Name:LIVING LOTUS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:SEXTON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:470-236-8131
Mailing Address - Street 1:PO BOX 637
Mailing Address - Street 2:
Mailing Address - City:BRASELTON
Mailing Address - State:GA
Mailing Address - Zip Code:30517-0011
Mailing Address - Country:US
Mailing Address - Phone:470-236-8131
Mailing Address - Fax:706-310-8113
Practice Address - Street 1:300 BROADWAY AVENUE
Practice Address - Street 2:
Practice Address - City:BRASELTON
Practice Address - State:GA
Practice Address - Zip Code:30517
Practice Address - Country:US
Practice Address - Phone:470-236-8131
Practice Address - Fax:706-310-8113
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty