Organization
BLOSSOMING LOTUS THERAPY LCSW PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JESSICA M HARDIAL MA, LCSW, PHD(C) (CEO)
(516) 254-9201
Entity
Organization
Contact information
Practice address
145 SUNRISE HWY STE 7, LINDENHURST, NY 11757-2500
(516) 254-9201
Mailing address
145 SUNRISE HWY STE 7, LINDENHURST, NY 11757-2500
(516) 254-9201
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1366893240
NPI
NY
Enumeration date
08/17/2021
Last updated
03/28/2023
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