Provider Demographics
NPI:1407248289
Name:SIMPLY AWAKE LLC
Entity Type:Organization
Organization Name:SIMPLY AWAKE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JONATHAN
Authorized Official - Middle Name:ERIC
Authorized Official - Last Name:LABMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:267-454-8034
Mailing Address - Street 1:6597 GREENHILL RD
Mailing Address - Street 2:
Mailing Address - City:LUMBERVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18933-9703
Mailing Address - Country:US
Mailing Address - Phone:267-454-8034
Mailing Address - Fax:
Practice Address - Street 1:4000 SAWMILL RD STE C2
Practice Address - Street 2:THE UNITY BARN
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18902-9645
Practice Address - Country:US
Practice Address - Phone:267-454-8034
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-03-03
Last Update Date:2015-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC005696101YM0800X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No251S00000XAgenciesCommunity/Behavioral HealthGroup - Multi-Specialty