Provider Demographics
NPI:1083191357
Name:SIMMONS, JOY LOREE (LPC)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:LOREE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:180 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-2330
Mailing Address - Country:US
Mailing Address - Phone:276-335-2243
Mailing Address - Fax:276-228-6064
Practice Address - Street 1:180 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-2330
Practice Address - Country:US
Practice Address - Phone:276-335-2243
Practice Address - Fax:276-228-6064
Is Sole Proprietor?:No
Enumeration Date:2018-07-19
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0701007717101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health