Healthcare Provider Details

I. General information

NPI: 1194645218
Provider Name (Legal Business Name): GENTLE SPACE WELLNESS AND COUNSELING, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2026
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 N LARKIN AVE STE 101
JOLIET IL
60435-3470
US

IV. Provider business mailing address

801 N LARKIN AVE STE 101
JOLIET IL
60435-3470
US

V. Phone/Fax

Practice location:
  • Phone: 815-242-7195
  • Fax:
Mailing address:
  • Phone: 815-242-7195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: EMMA J SINGLA
Title or Position: OWNER
Credential: LCSW
Phone: 815-242-7195