SAMUEL SIMMONS LADC NPI 1902281256

NPI Information

NPI: 1902281256
Provider Name: SAMUEL SIMMONS, LADC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3442 25TH AVE S
MINNEAPOLIS, MN
ZIP 55406
Phone: (612) 721-0106
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Samuel Simmons, LADC is an addiction (substance use disorder) counselor in Minneapolis, MN. Samuel Simmons, LADC NPI is 1902281256. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3442 25TH AVE S
MINNEAPOLIS, MN
ZIP 55406-504
Phone: (612) 721-0106

The enumeration date for this NPI number is 7/28/2015 and was last updated on 7/28/2015.

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)	300322	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	300322	OTHER	MINNESOTA	LADC

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: 4/28/2024

NPI Synchronization or Removal

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