Provider Demographics
NPI:1124644638
Name:SIMPLY CANDID COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:SIMPLY CANDID COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:SIGRID
Authorized Official - Middle Name:NIKKEA
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:LPCS
Authorized Official - Phone:202-991-0766
Mailing Address - Street 1:7515 NOVELLA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76134-4318
Mailing Address - Country:US
Mailing Address - Phone:202-991-0766
Mailing Address - Fax:
Practice Address - Street 1:3901 ARLINGTON HIGHLANDS BLVD STE 200280
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:TX
Practice Address - Zip Code:76018-6036
Practice Address - Country:US
Practice Address - Phone:202-991-0766
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-20
Last Update Date:2020-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX290574707Medicaid