Provider Demographics
NPI:1447074281
Name:LOTUS INTEGRATIVE MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:LOTUS INTEGRATIVE MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWER
Authorized Official - Prefix:MRS
Authorized Official - First Name:TARA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BENINCASA
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC, NCC
Authorized Official - Phone:518-355-5800
Mailing Address - Street 1:3761 CARMAN RD
Mailing Address - Street 2:
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12303-5418
Mailing Address - Country:US
Mailing Address - Phone:518-355-5800
Mailing Address - Fax:518-355-5801
Practice Address - Street 1:3761 CARMAN RD
Practice Address - Street 2:
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12303-5418
Practice Address - Country:US
Practice Address - Phone:518-355-5800
Practice Address - Fax:518-355-5801
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-08
Last Update Date:2024-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty