Blue Lotus Healing Center, Llc in Clayton - Clinical
Blue Lotus Healing Center, Llc - NPI 1922206416
Blue Lotus Healing Center, Llc is a Clinical in Clayton, North Carolina. Blue Lotus Healing Center, Llc practices all healthcare services and medical treatments related to Clinical. The NPI Number for Blue Lotus Healing Center, Llc is 1922206416. The last update date is 2015-04-02.
Blue Lotus Healing Center, Llc's current location address is Po Box 1831, Clayton, North Carolina. You can contact this provider via phone number 9199468644 and fax number 9193639971. The mailing address for Blue Lotus Healing Center, Llc is Po Box 1831, Clayton, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Blue Lotus Healing Center, Llc |
|---|---|
| Address | Po Box 1831, Clayton, North Carolina |
| Phone Number | 9199468644 |
| Fax Number | 9193639971 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | OWNER |
|---|---|
| Authorized Official Name | Ibrahim Nivien |
| Credentials | LCSW |
| Telephone Number | 9199468644 |
NPI Number Detail
| NPI Number | 1922206416 |
|---|---|
| Provider Enumeration Date | 2007-07-05 |
| Last Updated Date | 2015-04-02 |
Provider Mailing Address Detail
| Address | Po Box 1831 |
|---|---|
| City | Clayton |
| State | North Carolina (NC) |
| Post Code | 275281831 |
| Phone Number | 9199468644 |
| Fax Number | 9193639971 |
Provider's Primary Taxonomy Detail
| Speciality | Clinical |
|---|---|
| Taxonomy | 1041C0700X |
| Licence No | C004122 |
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Definition: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certif |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1415Y | NC | BCBS | |
| 6106317 | NC | -- |
Post Comment/ Review Below
What is the Blue Lotus Healing Center, Llc's 1922206416?
The Blue Lotus Healing Center, Llc's NPI (National Provider Identifier) Number is 1922206416. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Blue Lotus Healing Center, Llc is physically located?
The Blue Lotus Healing Center, Llc is situated at the following address: Po Box 1831, Clayton, NC 275281831.
What is Blue Lotus Healing Center, Llc's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Blue Lotus Healing Center, Llc's specialized field of practice is Clinical, and the corresponding taxonomy code that categorizes this area of specialization is 1041C0700X.
On what date did the Centers for Medicare & Medicaid Services issue the 1922206416 to Blue Lotus Healing Center, Llc?
The Blue Lotus Healing Center, Llc received its 1922206416 assignment from the Centers for Medicare & Medicaid Services on 2007-07-05.
As of what date were the details related to Blue Lotus Healing Center, Llc most recently updated or revised?
The information pertaining to Blue Lotus Healing Center, Llc, including its address, specialty, and other relevant details, was last updated or revised on 2015-04-02.
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