Healthcare Provider Details

I. General information

NPI: 1497327498
Provider Name (Legal Business Name): RACHEL SIMMONS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2021
Last Update Date: 02/24/2025
Certification Date: 02/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5310 E 31ST ST S
TULSA OK
74135-5018
US

IV. Provider business mailing address

20605 LYNN CIR
CLAREMORE OK
74019-1786
US

V. Phone/Fax

Practice location:
  • Phone: 918-600-3100
  • Fax:
Mailing address:
  • Phone: 918-260-4338
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number21102
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: