MEDICARE: GWEN SIMBECK LPC PLLC

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	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)

General Provider Information

NPI Number	:	1265265490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GWEN SIMBECK LPC PLLC

Provider Business Mailing Address
First Line	:	PO BOX 335
Second Line	:
City	:	PALMER LAKE
State	:	CO
Zip	:	80133-0335
Country	:	US
Telephone Number	:	719-481-6150
Fax Number	:	417-900-3147

Provider Business Practice Location Address
First Line	:	236 N WASHINGTON ST UNIT 7E
Second Line	:
City	:	MONUMENT
State	:	CO
Zip	:	80132-7185
Country	:	US
Telephone Number	:	719-481-6150
Fax Number	:	417-900-3147

Authorized Official
Title or Position	:	OWNER/THERAPIST
Name	:	GWEN EILEEN SIMBECK
Credential	:	MA, LPC
Telephone Number	:	719-481-6150

Provider Enumeration Date	:	08/22/2024
Last Update Date	:	02/07/2026

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