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General NPI Number Information
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NPI Number | 1760273189
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Entity Type | Individual
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Provider Name | SAMANTHA SIMMS
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Gender | Female
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Dates
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Enumeration Date | 05/15/2025
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 8500 SHOAL CREEK BLVD. BLDG. 4, #202
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City | AUSTIN
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State | TX
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Zip | 78757
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Country | US
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Telephone | 512-201-4501
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Fax |
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Provider Business Mailing Address
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Address Line | 1403 GATOR CREEK DR
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City | CEDAR PARK
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State | TX
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Zip | 78613-1449
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 83269
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License Number State | TX
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