NPIMap

Organization Active NPI

Lotus Wisdom Counseling Services, PLLC

  • Counselor
  • Winston Salem, NC
National Provider Identifier
1811599475
Registry record updated Jun 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
Legal business name
LOTUS WISDOM COUNSELING SERVICES, PLLC
Practice address
138 S Cherry St Ste 400
Winston Salem, NC 27101-5271
Phone
(336) 892-9061
Fax
(336) 899-0170
NPI assigned
Nov 9, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 4, 2021

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

Authorized official

Name
Brittany Nichole Bodwell, LCMHCNPI 1679963805
Title
Owner/Therapist
Phone
(336) 892-9061

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101Y00000X Primary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X

Addresses

Primary practice location

138 S Cherry St Ste 400
Winston Salem, NC 27101-5271

Mailing address

138 S Cherry St Ste 400
Winston Salem, NC 27101-5271
Phone (336) 892-9061

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251002002706 NC Part B Supplier - Clinic/Group Practice 0143726778 Receives reassigned benefits from 1 practitioner
Practice locations: Winston Salem, NC

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1622764800000",
    "number": "1811599475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "138 S CHERRY ST STE 400",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015271",
            "telephone_number": "336-892-9061",
            "fax_number": "336-899-0170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "138 S CHERRY ST STE 400",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271015271",
            "telephone_number": "336-892-9061",
            "fax_number": "336-899-0170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LOTUS WISDOM COUNSELING SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-11-09",
        "last_updated": "2021-06-04",
        "certification_date": "2021-06-04",
        "status": "A",
        "authorized_official_last_name": "BODWELL",
        "authorized_official_first_name": "BRITTANY",
        "authorized_official_middle_name": "NICHOLE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "336-892-9061",
        "authorized_official_credential": "LCMHC"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.