Provider Demographics
NPI:1710738570
Name:SIMPLE ESSENCE COUNSELING & WELLNESS
Entity Type:Organization
Organization Name:SIMPLE ESSENCE COUNSELING & WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/ CEO
Authorized Official - Prefix:
Authorized Official - First Name:LA.THIANG
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNOLD
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:217-853-7430
Mailing Address - Street 1:2500 VILLAGE PARK DR APT 205
Mailing Address - Street 2:
Mailing Address - City:WAUKEGAN
Mailing Address - State:IL
Mailing Address - Zip Code:60087-4105
Mailing Address - Country:US
Mailing Address - Phone:217-853-7430
Mailing Address - Fax:
Practice Address - Street 1:2500 VILLAGE PARK DR APT 205
Practice Address - Street 2:
Practice Address - City:WAUKEGAN
Practice Address - State:IL
Practice Address - Zip Code:60087-4105
Practice Address - Country:US
Practice Address - Phone:217-853-7430
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty