Healthcare Provider Details

I. General information

NPI: 1386553956
Provider Name (Legal Business Name): JESSICA DANIELLE SIMMS LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 PENTLOW AVE
NEW BRITAIN CT
06053-1624
US

IV. Provider business mailing address

50 PENTLOW AVE
NEW BRITAIN CT
06053-1624
US

V. Phone/Fax

Practice location:
  • Phone: 959-279-3877
  • Fax:
Mailing address:
  • Phone: 959-279-3877
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number10567
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: