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General NPI Number Information
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NPI Number | 1689055725
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Entity Type | Individual
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Provider Name | GINA MARIE SIMMONS LPC,CAC III, MA
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Gender | Female
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Dates
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Enumeration Date | 06/15/2015
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Last Update Date | 01/25/2022
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Provider Practice Location Address
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Address Line | 2956 GINNALA DR STE 205
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City | LOVELAND
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State | CO
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Zip | 80538-7825
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Country | US
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Telephone | 907-599-1523
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Fax |
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Provider Business Mailing Address
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Address Line | 224 N SAINT LOUIS AVE
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City | LOVELAND
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State | CO
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Zip | 80537-5866
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Country | US
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Telephone | 970-599-1523
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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 | ACC.0020880
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License Number State | CO
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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 | LPC.0015178
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License Number State | CO
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