Provider Demographics
NPI:1497345425
Name:AWAKENING, LLC
Entity Type:Organization
Organization Name:AWAKENING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER & PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CUECHE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:812-639-3138
Mailing Address - Street 1:1133 W MILL RD STE 211
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47710-3806
Mailing Address - Country:US
Mailing Address - Phone:812-612-1488
Mailing Address - Fax:812-203-8518
Practice Address - Street 1:1130 W MILL RD STE 211
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-3801
Practice Address - Country:US
Practice Address - Phone:812-639-3138
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-23
Last Update Date:2021-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)