Organization · Type 2 NPI

Black Lotus Therapy

Mental Health Counselor · Medford, OR

NPI number 1720696289 Active

Practice location

10 Crater Lake Ave Ste 25
Medford, OR 97504-7445

Call (541) 500-8655 Map

Fax (800) 433-1396

Mailing address

PO Box 4752
Medford, OR 97501-0197

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor Primary 101YM0800XNone listed

Mental Health Counselor: Definition to come...

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About NPI 1720696289

Black Lotus Therapy's National Provider Identifier is 1720696289, issued on Jul 21, 2020. The primary taxonomy on file is Mental Health Counselor (101YM0800X), and the practice location is in Medford, OR. The record was last updated on Mar 4, 2021.