Lotus Moon Counseling Centre

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

001496 Issued in CT

Legal business name

LOTUS MOON COUNSELING CENTRE

Practice address

148 Route 2
Preston, CT 06365-8520

Phone

(860) 859-3341

Fax

(860) 760-6666

NPI assigned

Nov 8, 2007

Last updated

Nov 8, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Wendy St. George, LPC, BCPC

Title

Owner/Counselor

Phone

(860) 859-3341

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1194480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194480000000",
    "number": "1366622144",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "148 ROUTE 2",
            "city": "PRESTON",
            "state": "CT",
            "postal_code": "063658520",
            "telephone_number": "860-859-3341",
            "fax_number": "860-760-6666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 ROUTE 2",
            "city": "PRESTON",
            "state": "CT",
            "postal_code": "063658520",
            "telephone_number": "860-859-3341",
            "fax_number": "860-760-6666"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS MOON COUNSELING CENTRE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-08",
        "last_updated": "2007-11-08",
        "status": "A",
        "authorized_official_last_name": "ST. GEORGE",
        "authorized_official_first_name": "WENDY",
        "authorized_official_title_or_position": "OWNER/COUNSELOR",
        "authorized_official_telephone_number": "860-859-3341",
        "authorized_official_credential": "LPC, BCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001496",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "004271144",
            "state": "CT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.