NPIMap

Organization Active NPI

Black Lotus Counseling

  • Professional Counselor
  • Reading, PA
National Provider Identifier
1831833672
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Legal business name
BLACK LOTUS COUNSELING
Practice address
10 S Los Robles CT
Reading, PA 19606-1535
Phone
(702) 350-6107
NPI assigned
Apr 27, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Authorized official

Name
Angela M Keller, MS, LPC, LCPCNPI 1114576048
Title
Owner
Phone
(484) 599-6420

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YP2500X Primary

Addresses

Primary practice location

10 S Los Robles CT
Reading, PA 19606-1535

Mailing address

1167 Berkshire Blvd # 1033
Wyomissing, PA 19610-1244
Phone (484) 599-2640

Other names 1

  • Rebellious Wellness Former legal business name

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL angelakellercounseling@gmail.com Direct Angela Keller

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": "1651017600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1651017600000",
    "number": "1831833672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1167 BERKSHIRE BLVD # 1033",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101244",
            "telephone_number": "484-599-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 S LOS ROBLES CT",
            "city": "READING",
            "state": "PA",
            "postal_code": "196061535",
            "telephone_number": "702-350-6107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLACK LOTUS COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-27",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A",
        "authorized_official_last_name": "KELLER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "484-599-6420",
        "authorized_official_credential": "MS, LPC, LCPC"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "angelakellercounseling@gmail.com",
            "affiliation": "Y",
            "endpointDescription": "email",
            "affiliationName": "Angela Keller",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "10 S Los Robles Ct",
            "city": "Reading",
            "state": "PA",
            "country_code": "US",
            "postal_code": "196061535",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Rebellious Wellness",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Reading, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; 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.