| Black Lotus Counseling Center | |
|
2431 Bethany Rd Ste B Sycamore IL 60178-3136 | |
| (815) 993-8724 | |
| Not Available |
| Full Name | Black Lotus Counseling Center |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 2431 Bethany Rd Ste B, Sycamore, Illinois |
| Authorized Official Name and Position | Matthew E Sprong (PRESIDENT) |
| Authorized Official Contact | 8159938724 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Black Lotus Counseling Center 2431 Bethany Rd Ste B Sycamore IL 60178-3136 Ph: (815) 993-8724 | Black Lotus Counseling Center 2431 Bethany Rd Ste B Sycamore IL 60178-3136 Ph: (815) 993-8724 |
| NPI Number | 1275321796 |
|---|---|
| Provider Enumeration Date | 04/25/2025 |
| Last Update Date | 04/25/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275321796 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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