Provider Demographics
NPI:1144782442
Name:SIMONDS, CARRIE (LPC-S)
Entity Type:Individual
Prefix:
First Name:CARRIE
Middle Name:
Last Name:SIMONDS
Suffix:
Gender:F
Credentials:LPC-S
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1019 IRON MESA
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78260-2577
Mailing Address - Country:US
Mailing Address - Phone:210-884-7743
Mailing Address - Fax:
Practice Address - Street 1:3201 CHERRY RIDGE ST STE C318
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78230-4826
Practice Address - Country:US
Practice Address - Phone:210-884-7743
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-04
Last Update Date:2019-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX62072101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional