Provider Demographics
NPI:1073239125
Name:SIMMONS, ABIGAIL CHARIN (MFT-A)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:CHARIN
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MFT-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HENRY CT
Mailing Address - Street 2:
Mailing Address - City:NICHOLASVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40356-2227
Mailing Address - Country:US
Mailing Address - Phone:859-780-2442
Mailing Address - Fax:
Practice Address - Street 1:2285 EXECUTIVE DR
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40505-4810
Practice Address - Country:US
Practice Address - Phone:859-780-2442
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY271197106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist