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NPI Code Detail

MEDICARE: THE SIMPLICITY IN AUTHENTICITY COUNSELING, LLC

MEDICARE: THE SIMPLICITY IN AUTHENTICITY COUNSELING, 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
1261QM0801XMental Health Clinic/Center (Including Community Mental Health Center)
2101YP2500XProfessional Counselor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1427790138
Entity Type Code : Organization
Provider Name (Legal Business Name) : THE SIMPLICITY IN AUTHENTICITY COUNSELING, LLC
Provider Business Mailing Address
First Line : PO BOX 211
Second Line :
City : DEFOREST
State : WI
Zip : 53532-0211
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 811 E WASHINGTON AVE STE 400
Second Line :
City : MADISON
State : WI
Zip : 53703-4028
Country : US
Telephone Number : 608-389-0253
Fax Number :
Authorized Official
Title or Position : PSYCHOTHERAPIST
Name : MS. GABRIELA RUTH JUMP
Credential : LPC
Telephone Number : 608-389-0253
Provider Enumeration Date : 04/12/2022
Last Update Date : 05/21/2024

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Directions to “THE SIMPLICITY IN AUTHENTICITY COUNSELING, LLC ” Practice Location

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