Healthcare Provider Details

I. General information

NPI: 1578120168
Provider Name (Legal Business Name): CHRISTINE SIMMS MS, LMFT, LPCC, LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/20/2019
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

784 S CLEARWATER LOOP STE R
POST FALLS ID
83854-9599
US

IV. Provider business mailing address

PO BOX 923
PAYETTE ID
83661-0923
US

V. Phone/Fax

Practice location:
  • Phone: 909-345-0601
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5971392
License Number StateID
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16632
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number145740
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: