Healthcare Provider Details

I. General information

NPI: 1306640263
Provider Name (Legal Business Name): REGINA SIMMONS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: REGINA SIMMONS

II. Dates (important events)

Enumeration Date: 04/01/2025
Last Update Date: 04/01/2025
Certification Date: 04/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 W 7TH ST
PLAINFIELD NJ
07060-1511
US

IV. Provider business mailing address

1120 PLAINFIELD AVE
PLAINFIELD NJ
07060-2723
US

V. Phone/Fax

Practice location:
  • Phone: 908-755-1511
  • Fax:
Mailing address:
  • Phone: 908-917-3754
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNJ

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: