MEDICARE: MICHAEL SIMMS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	5346	NC

General Provider Information

NPI Number	:	1184630246
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL SIMMS

Provider Business Mailing Address
First Line	:	3012 DARDEN RD APT A
Second Line	:
City	:	GREENSBORO
State	:	NC
Zip	:	27407-6834
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	915 S MAIN ST
Second Line	:
City	:	BURLINGTON
State	:	NC
Zip	:	27215-5756
Country	:	US
Telephone Number	:	336-229-5905
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/31/2006
Last Update Date	:	10/29/2008

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Directions to “ MICHAEL SIMMS ” Practice Location

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