Provider Demographics
NPI:1609605385
Name:PURPLE LOTUS SOLUTIONS, INC.
Entity type:Organization
Organization Name:PURPLE LOTUS SOLUTIONS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CLINICAL THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MINDY
Authorized Official - Middle Name:M
Authorized Official - Last Name:BURKHAMER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW, CADC, CODP-II
Authorized Official - Phone:630-337-0827
Mailing Address - Street 1:2683 US HIGHWAY 34
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:IL
Mailing Address - Zip Code:60543-8577
Mailing Address - Country:US
Mailing Address - Phone:630-337-0827
Mailing Address - Fax:
Practice Address - Street 1:2683 US HIGHWAY 34
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:IL
Practice Address - Zip Code:60543-8577
Practice Address - Country:US
Practice Address - Phone:630-337-0827
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-30
Last Update Date:2024-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty