Blue Lotus Healing Center, LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004122 Issued in NC

Legal business name

BLUE LOTUS HEALING CENTER, LLC

Practice address

8838 US Highway 70 W
Suite 200C
Clayton, NC 27520-4822

Phone

(919) 946-8644

Fax

(919) 550-2913

NPI assigned

Jul 5, 2007

Last updated

Apr 2, 2015By 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

Nivien Ibrahim, LCSWNPI 1275605347

Title

Owner

Phone

(919) 946-8644

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nivien Ibrahim, LCSW

  • Clinical Social Worker
  • Clayton, NC
  • NPI 1275605347
  Authorized official Same address or phone

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1427932800000",
    "number": "1922206416",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1831",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275281831",
            "telephone_number": "919-946-8644",
            "fax_number": "919-363-9971"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8838 US HIGHWAY 70 W",
            "address_2": "SUITE 200C",
            "city": "CLAYTON",
            "state": "NC",
            "postal_code": "275204822",
            "telephone_number": "919-946-8644",
            "fax_number": "919-550-2913"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BLUE LOTUS HEALING CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2015-04-02",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "NIVIEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "919-946-8644",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004122",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6106317",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1415Y",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• George William Bliss III, PHARMD
• Zachary J Bloom, M.D.
• Blooming Expressions Therapy, PLLC
• Blossoming Beginnings, LLC
• Montressa Monique Blount, NP
• Suzanne Elizabeth Boak, LMSW, ACSW
• Sanita Boateng, PHARMD
• Patricia S. Bock, L.C.A.S, L.C.S.W.
• Aryan Kathryn Bogle, LCSW
• Taria Bonaparte, MA

• Clinical Social Worker in Clayton, NC
• Providers in Clayton, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2015; 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.