Healthcare Provider Details

I. General information

NPI: 1982511580
Provider Name (Legal Business Name): POLK SIMMONS COUNSELING GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/27/2026
Last Update Date: 08/27/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

390 COMMERCE DR # 367
FORT WASHINGTON PA
19034-2600
US

IV. Provider business mailing address

390 COMMERCE DR # 367
FORT WASHINGTON PA
19034-2600
US

V. Phone/Fax

Practice location:
  • Phone: 856-803-4393
  • Fax:
Mailing address:
  • Phone: 856-803-4393
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL

VIII. Authorized Official

Name: DANIEL SIMMONS
Title or Position: OWNER
Credential:
Phone: 856-803-4393