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Organization
LOTUS TRAUMA CARE, LLC
Active
Organization
LOTUS TRAUMA CARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHAUNTAY BRENORD LCSW (CO-FOUNDER, TRAUMA THERAPIST)
(630) 201-0838
Entity
Organization
Contact information
Practice address
503 E 61ST ST, CHICAGO, IL 60637-2406
(872) 233-8207
Mailing address
503 E 61ST ST, CHICAGO, IL 60637-2406
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
251S00000X
Community/Behavioral Health Agency
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Enumeration date
08/07/2017
Last updated
08/07/2017
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