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Individual

LISA LOTUS LOVE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
1600 SLEATER KINNEY RD SE, LACEY, WA 98503-2500
(360) 438-5000
(360) 438-7785
Mailing address
1600 SLEATER KINNEY RD SE, LACEY, WA 98503-2500
(360) 438-5000
(360) 438-7785

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
SC60789696
WA
1041C0700X
Clinical Social Worker
Primary
SC60789696
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
91-0666889
WA
Enumeration date
09/18/2018
Last updated
03/08/2024
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