MEDICARE: DR. DENISE REGINA WARREN-SIMMONS RN, PMHNP-C, FNE

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
1	103K00000X	Behavior Analyst	26NF00083600	NJ
2	251S00000X	Community/Behavioral Health Agency	26NJ15291400	NJ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	26NJ15291400	NJ
4	253Z00000X	In Home Supportive Care Agency	26NR108476800	NJ
5	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	404606	NY

General Provider Information

NPI Number	:	1588172662
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DENISE REGINA WARREN-SIMMONS RN, PMHNP-C, FNE

Provider Business Mailing Address
First Line	:	290 SPRINGFIELD AVE UNIT 8001
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07103-7000
Country	:	US
Telephone Number	:	973-508-3161
Fax Number	:	972-424-9339

Provider Business Practice Location Address
First Line	:	290 SPRINGFIELD AVE UNIT 8001
Second Line	:
City	:	NEWARK
State	:	NJ
Zip	:	07108-7002
Country	:	US
Telephone Number	:	973-508-3161
Fax Number	:	973-242-9339

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2018
Last Update Date	:	04/13/2026

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