| Healing Lotus Mental Health Llc | |
|
885 S Janesville St Whitewater WI 53190-2526 | |
| (262) 288-0819 | |
| Not Available |
| Full Name | Healing Lotus Mental Health Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 885 S Janesville St, Whitewater, Wisconsin |
| Authorized Official Name and Position | Amy Porter (OWNER/ LPC, CSAC) |
| Authorized Official Contact | 2622880819 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Healing Lotus Mental Health Llc Po Box 470 Whitewater WI 53190-0470 Ph: (262) 288-0819 | Healing Lotus Mental Health Llc 885 S Janesville St Whitewater WI 53190-2526 Ph: (262) 288-0819 |
| NPI Number | 1245004548 |
|---|---|
| Provider Enumeration Date | 11/08/2023 |
| Last Update Date | 11/08/2023 |
| Certification Date | 11/08/2023 |
| Medicare PECOS PAC ID | 8325491038 |
|---|---|
| Medicare Enrollment ID | O20240130000959 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245004548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM0801X | Clinic/center - Mental Health (including Community Mental Health Center) | (* (Not Available)) | Primary |
| Provider Name | Amy Porter |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1295132702 PECOS PAC ID: 7416309299 Enrollment ID: I20240117002109 |
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