| Light & Lotus Wellness Pllc | |
|
202 6th St Ste 301e Castle Rock CO 80104-1731 | |
| (720) 515-4710 | |
| Not Available |
| Full Name | Light & Lotus Wellness Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 202 6th St Ste 301e, Castle Rock, Colorado |
| Authorized Official Name and Position | Stacey Hostetter (OWNER) |
| Authorized Official Contact | 7205154710 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Light & Lotus Wellness Pllc 202 6th St Ste 301e Castle Rock CO 80104-1731 Ph: (720) 515-4710 | Light & Lotus Wellness Pllc 202 6th St Ste 301e Castle Rock CO 80104-1731 Ph: (720) 515-4710 |
| NPI Number | 1598531204 |
|---|---|
| Provider Enumeration Date | 12/04/2023 |
| Last Update Date | 12/04/2023 |
| Certification Date | 12/04/2023 |
| Medicare PECOS PAC ID | 8820448558 |
|---|---|
| Medicare Enrollment ID | O20231221001211 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598531204 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Stacey A Hostetter |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1558766584 PECOS PAC ID: 6608148283 Enrollment ID: I20170816002542 |
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