Provider Demographics
NPI:1982435434
Name:LUNAR LOTUS COUNSELING PLLC
Entity type:Organization
Organization Name:LUNAR LOTUS COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC-ASSOCIATE / FOUNDER
Authorized Official - Prefix:
Authorized Official - First Name:JENNY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAU
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:512-270-1064
Mailing Address - Street 1:6001 W PARMER LN STE 370
Mailing Address - Street 2:#72
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78727-3908
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11824 JOLLYVILLE RD STE 103
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78759-2318
Practice Address - Country:US
Practice Address - Phone:512-270-1064
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-08
Last Update Date:2024-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty