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NPI Code Detail

MEDICARE: LAURA G SIMMONS

MEDICARE: LAURA G SIMMONS
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
1101YM0800XMental Health CounselorA1803029AR

General Provider Information

NPI Number : 1396247375
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA G SIMMONS
Provider Business Mailing Address
First Line : 3285 E SKILLERN RD
Second Line :
City : FAYETTEVILLE
State : AR
Zip : 72703-4626
Country : US
Telephone Number : 479-966-9895
Fax Number :
Provider Business Practice Location Address
First Line : 1814 S 26TH ST
Second Line :
City : ROGERS
State : AR
Zip : 72758-1386
Country : US
Telephone Number : 479-966-9895
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2018
Last Update Date : 05/30/2025

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Directions to “ LAURA G SIMMONS ” Practice Location

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