Provider Demographics
NPI:1083158059
Name:SIMMONS, ANNA (MA, NCC, LPC)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MA, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 COOMBS FARM RD
Mailing Address - Street 2:BUILDING B, SUITE 106
Mailing Address - City:MORGANTOWN
Mailing Address - State:WV
Mailing Address - Zip Code:26508-0053
Mailing Address - Country:US
Mailing Address - Phone:304-241-5100
Mailing Address - Fax:
Practice Address - Street 1:2000 COOMBS FARM RD
Practice Address - Street 2:BUILDING B, SUITE 106
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-0053
Practice Address - Country:US
Practice Address - Phone:304-241-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-12-11
Last Update Date:2016-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2255101YM0800X, 101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health