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General NPI Number Information
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NPI Number | 1083482210
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Entity Type | Individual
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Provider Name | MARY SIMMS LPC
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Gender | Female
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Dates
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Enumeration Date | 12/18/2023
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Last Update Date | 02/03/2025
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Provider Practice Location Address
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Address Line | 861 E ALLEGHENY AVE
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City | PHILADELPHIA
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State | PA
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Zip | 19134-2401
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Country | US
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Telephone | 215-302-3600
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Fax | 215-329-2369
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Provider Business Mailing Address
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Address Line | 35 N PRESTON ST
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City | PHILADELPHIA
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State | PA
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Zip | 19104-2258
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 0701011650
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | PC016646
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PC016646
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License Number State | PA
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