MEDICARE: ALIGNED ESSENCE THERAPY, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1669330684
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALIGNED ESSENCE THERAPY, LLC

Provider Business Mailing Address
First Line	:	1207 DELAWARE AVE UNIT 3086
Second Line	:
City	:	WILMINGTON
State	:	DE
Zip	:	19806-4753
Country	:	US
Telephone Number	:	708-653-0877
Fax Number	:

Provider Business Practice Location Address
First Line	:	18846 KEELER AVE
Second Line	:
City	:	COUNTRY CLUB HILLS
State	:	IL
Zip	:	60478-5669
Country	:	US
Telephone Number	:	708-653-0877
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	TIA NIX
Credential	:	LCSW
Telephone Number	:	708-653-0877

Provider Enumeration Date	:	01/10/2026
Last Update Date	:	03/16/2026

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