OrganizationActive
Black Lotus Therapy
NPI 1720696289 · Mental Health Counselor · Medford, OR
Black Lotus Therapy is a Mental Health Counselor organization in Medford, OR (NPI 1720696289).
Provider details
- NPI number
- 1720696289
- Entity type
- Organization
- Primary specialty
- Mental Health CounselorBehavioral Health & Social Service Providers
- Organization subpart
- No
- Authorized official
- Tristin Victor, Owner(541) 500-8655
Specialties & taxonomies
Behavioral Health & Social Service Providers
Profile Score
Established profile(64/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10 Crater Lake Ave Ste 25
Medford, OR 97504-7445
Phone: (541) 500-8655
Fax: (800) 433-1396
Street-level locationGet directions
Mailing address
Po Box 4752
Medford, OR 97501-0197
Registry dates
- Enumerated
- 2020-07-21
- Last updated
- 2021-03-04
- Certified
- 2021-03-04
Frequently asked questions
- What is Black Lotus Therapy's NPI number?
- Black Lotus Therapy's National Provider Identifier (NPI) is 1720696289, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Black Lotus Therapy?
- Black Lotus Therapy is classified in the NPPES registry as Mental Health Counselor (Behavioral Health & Social Service Providers).
- Where is Black Lotus Therapy located?
- Black Lotus Therapy's practice location on file with NPPES is 10 Crater Lake Ave Ste 25, Medford, OR 97504-7445.
- What is Black Lotus Therapy's phone number?
- The practice phone number listed in the NPPES registry for Black Lotus Therapy is (541) 500-8655.
- Who is the authorized official for Black Lotus Therapy?
- The authorized official listed on Black Lotus Therapy's NPPES record is Tristin Victor, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Black Lotus Therapy's NPI active?
- Yes — Black Lotus Therapy's NPI (1720696289) is active in the NPPES registry as of the last update on 2021-03-04.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.