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General NPI Number Information
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NPI Number | 1578942256
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Entity Type | Individual
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Provider Name | ANGELA DW SIMMONS LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/27/2015
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Last Update Date | 11/06/2020
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Provider Practice Location Address
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Address Line | 130 KINGS DAUGHTERS DR
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City | FRANKFORT
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State | KY
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Zip | 40601-4248
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Country | US
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Telephone | 502-219-7762
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Fax | 502-223-7491
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Provider Business Mailing Address
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Address Line | 209 CARDINAL AVE
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City | VERSAILLES
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State | KY
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Zip | 40383-1113
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Country | US
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Telephone | 502-219-7762
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Fax | 502-223-7491
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1106
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License Number State | KY
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