Provider Demographics
NPI:1427790138
Name:THE SIMPLICITY IN AUTHENTICITY COUNSELING, LLC
Entity type:Organization
Organization Name:THE SIMPLICITY IN AUTHENTICITY COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:GABRIELA
Authorized Official - Middle Name:RUTH
Authorized Official - Last Name:JUMP
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:608-389-0253
Mailing Address - Street 1:PO BOX 211
Mailing Address - Street 2:
Mailing Address - City:DEFOREST
Mailing Address - State:WI
Mailing Address - Zip Code:53532-0211
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:811 E WASHINGTON AVE STE 400
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53703-4028
Practice Address - Country:US
Practice Address - Phone:608-389-0253
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-12
Last Update Date:2024-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI4334-226Medicaid