| Lotus Behavioral Wellness | |
|
100 Illinois St Ste 200 St Charles IL 60174-1867 | |
| (779) 777-5361 | |
| Not Available |
| Full Name | Lotus Behavioral Wellness |
|---|---|
| Speciality | Social Worker |
| Location | 100 Illinois St Ste 200, St Charles, Illinois |
| Authorized Official Name and Position | Megan A Orr (THERAPIST) |
| Authorized Official Contact | 7797775361 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Lotus Behavioral Wellness 100 Illinois St Ste 200 St Charles IL 60174-1867 Ph: (779) 777-5361 | Lotus Behavioral Wellness 100 Illinois St Ste 200 St Charles IL 60174-1867 Ph: (779) 777-5361 |
| NPI Number | 1558944512 |
|---|---|
| Provider Enumeration Date | 04/28/2021 |
| Last Update Date | 04/28/2021 |
| Certification Date | 04/28/2021 |
| Medicare PECOS PAC ID | 3476952565 |
|---|---|
| Medicare Enrollment ID | O20210521001214 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1558944512 | NPI | - | NPPES |
| 149018326 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Megan A Orr |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528420346 PECOS PAC ID: 5597064170 Enrollment ID: I20160503001974 |
| Provider Name | Stephanie Nicole Polan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1205295557 PECOS PAC ID: 6608249826 Enrollment ID: I20230308001715 |
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