Healthcare Provider Details

I. General information

NPI: 1881476315
Provider Name (Legal Business Name): COUNSELING SIMPLIFIED
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/18/2023
Last Update Date: 06/26/2024
Certification Date: 06/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1435 WIN HENTSCHEL BLVD STE B122
WEST LAFAYETTE IN
47906-4147
US

IV. Provider business mailing address

610 INDIAN BEAD RD
LAFAYETTE IN
47909-8900
US

V. Phone/Fax

Practice location:
  • Phone: 574-398-8944
  • Fax:
Mailing address:
  • Phone: 574-398-8944
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name: MRS. CARALYN MARIE WENDLING
Title or Position: PRESIDENT
Credential: M.S.
Phone: 574-398-8944