Healthcare Provider Details

I. General information

NPI: 1104579549
Provider Name (Legal Business Name): LORNA T. SIMMONS APEX CLINICAL COUNSELING, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2022
Last Update Date: 05/01/2022
Certification Date: 05/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

189 WIND CHIME CT STE 202
RALEIGH NC
27615-6480
US

IV. Provider business mailing address

3140 RETAMA RUN
NEW HILL NC
27562-9345
US

V. Phone/Fax

Practice location:
  • Phone: 919-355-6236
  • Fax:
Mailing address:
  • Phone: 919-355-6236
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: LORNA THERESE VANDEN HEUVEL
Title or Position: OWNER AND THERAPIST
Credential: LCSWA, LCAS
Phone: 919-355-6236