Provider Demographics
NPI:1174394266
Name:UNFOLDING THE LOTUS HEALING
Entity type:Organization
Organization Name:UNFOLDING THE LOTUS HEALING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:SHANDA
Authorized Official - Middle Name:INEZ
Authorized Official - Last Name:MROZ
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC, LICDC, NCC
Authorized Official - Phone:513-549-1227
Mailing Address - Street 1:20464 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47025-9019
Mailing Address - Country:US
Mailing Address - Phone:513-939-9236
Mailing Address - Fax:
Practice Address - Street 1:455 DELTA AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45226-1127
Practice Address - Country:US
Practice Address - Phone:513-549-1227
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty