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General NPI Number Information
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NPI Number | 1891030862
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Entity Type | Organization
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Legal Business Name | SIMMONS COUNSELING SERVICES
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Dates
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Enumeration Date | 12/03/2012
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Last Update Date | 10/04/2021
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Provider Practice Location Address
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Address Line | 206 W SYBELIA AVE
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City | MAITLAND
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State | FL
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Zip | 32751-4739
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Country | US
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Telephone | 321-332-8540
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Fax |
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Provider Business Mailing Address
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Address Line | 206 W SYBELIA AVE
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City | MAITLAND
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State | FL
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Zip | 32751-4739
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Country | US
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Telephone | 321-332-8540
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID JEREMIAH SIMMONS
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Credential |
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Telephone | 321-332-8540
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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 | 10958
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License Number State | FL
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