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Black Lotus Therapy
Mental Health Counselor in Medford, Oregon
NPI 1720696289

Black Lotus Therapy is a Mental Health Counselor based in Medford, OR and is specialized in Mental Health. Black Lotus Therapy practices in Medford, OR. The NPI Number for Black Lotus Therapy is 1720696289 and holds a License No. (Oregon).

The current practice location address for Black Lotus Therapy is 10 Crater Lake Ave Ste 25, Medford, OR and can be reached out via phone at 541-500-8655 and via fax at 800-433-1396.

Location: 10 Crater Lake Ave Ste 25, Medford, OR, 97501-0197
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1720696289
Provider Name
Black Lotus Therapy
Credential
Provider Entity Type
Organization
Address
10 Crater Lake Ave Ste 25, Medford, OR, 97501-0197
Phone Number
541-500-8655
Fax Number
800-433-1396
Provider Enumeration Date
07/21/2020
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
10 Crater Lake Ave Ste 25
City
Medford
State
Oregon
Zip
97504-7445
Phone Number
541-500-8655
Fax Number
800-433-1396
person
Provider Business Mailing Address Details
Address
10 Crater Lake Ave Ste 25
City
Medford
State
Oregon
Zip
97504-7445
Phone Number
541-500-8655
Fax Number
800-433-1396
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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