Organization
BLACK LOTUS COUNSELING CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW E SPRONG (PRESIDENT)
(815) 993-8724
Entity
Organization
Contact information
Practice address
2431 BETHANY RD STE B, SYCAMORE, IL 60178-3136
(815) 993-8724
Mailing address
2431 BETHANY RD STE B, SYCAMORE, IL 60178-3136
(815) 993-8724
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
04/25/2025
Last updated
04/25/2025
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