Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Mental Health |
101YM0800X | |||
Clinical |
1041C0700X | 80 | Licensed Clinical Social Worker |
| NPI Number | 1265304562 |
| LBN Legal business name | LIVING LOTUS |
| Authorized official | JESSICA SEXTON - (OWNER) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | 09/18/2025 |
| Last updated | 09/18/2025 - About 9 months ago |
| Identifiers | n/a |
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