Provider Demographics
NPI:1962362806
Name:EMBODIED HEALING COUNSELING AND YOGA
Entity type:Organization
Organization Name:EMBODIED HEALING COUNSELING AND YOGA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:KRISTEN
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMONS
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:224-307-4736
Mailing Address - Street 1:832 DEMPSTER ST
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:IL
Mailing Address - Zip Code:60202-1342
Mailing Address - Country:US
Mailing Address - Phone:224-307-4736
Mailing Address - Fax:
Practice Address - Street 1:832 DEMPSTER ST
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:IL
Practice Address - Zip Code:60202-1342
Practice Address - Country:US
Practice Address - Phone:224-307-4736
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-11-13
Last Update Date:2025-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty