MRS. NIKISHA LYNNETTE SIMMONS-MACLIN LADC NPI 1063870905

NPI Information

NPI: 1063870905
Provider Name: MRS. NIKISHA LYNNETTE SIMMONS-MACLIN, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
10026 UNIVERSITY AVE NW STE 103
COON RAPIDS, MN
ZIP 55448
Phone: (612) 636-9677
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MRS. Nikisha Lynnette Simmons-maclin, LADC is an addiction (substance use disorder) counselor in Coon Rapids, MN. MRS. Nikisha Lynnette Simmons-maclin, LADC NPI is 1063870905. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10026 UNIVERSITY AVE NW STE 103
COON RAPIDS, MN
ZIP 55448-213
Phone: (612) 636-9677

The enumeration date for this NPI number is 2/6/2016 and was last updated on 1/30/2019.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	304191	MINNESOTA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	304191	OTHER	MINNESOTA	MINNESOTA BOARD OF BEHAVIOR HEALTH
2	1098948	OTHER	MINNESOTA	MINNESOTA DEPARTMENT OF HUMAN SERVICES

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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