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General NPI Number Information
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NPI Number | 1457844649
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Entity Type | Individual
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Provider Name | MICHAEL WILSON SIMMS LCSW, LAC, ADS
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Gender | Male
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Dates
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Enumeration Date | 06/12/2018
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 90 MADISON ST STE 308
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City | DENVER
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State | CO
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Zip | 80206-5412
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Country | US
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Telephone | 720-656-5571
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Fax |
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Provider Business Mailing Address
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Address Line | 17095 E 105TH AVE
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City | COMMERCE CITY
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State | CO
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Zip | 80022-0570
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Country | US
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Telephone | 720-656-5571
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | ACD.0001089
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | CSW.09926662
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | CSW.09926662
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License Number State | CO
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