Organization
LOTUS COUNSELING INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHRYN GANDOLPH LICSW (PRESIDENT)
(612) 207-4103
Entity
Organization
Contact information
Practice address
1409 WILLOW ST STE 109, MINNEAPOLIS, MN 55403-2241
(612) 405-9395
Mailing address
3309 LIBRARY LN, ST LOUIS PARK, MN 55426-4210
(612) 207-4103
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1891060562
—
MN
Enumeration date
07/26/2019
Last updated
07/26/2019
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