Healthcare Provider Details

I. General information

NPI: 1346104395
Provider Name (Legal Business Name): CATHERINE MCCREA SIMKINS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

355 S MAIN ST FL 1
GREENVILLE SC
29601-2923
US

IV. Provider business mailing address

4001 PELHAM RD APT 184
GREER SC
29650-4331
US

V. Phone/Fax

Practice location:
  • Phone: 855-832-6727
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106S00000X
TaxonomyBehavior Technician
License NumberRBT-24-396094
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: