Provider Demographics
NPI:1235453861
Name:SIMMONDS, CHANA (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:CHANA
Middle Name:
Last Name:SIMMONDS
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:878 QUEEN ANNE RD
Mailing Address - Street 2:
Mailing Address - City:TEANECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07666-4623
Mailing Address - Country:US
Mailing Address - Phone:201-836-1776
Mailing Address - Fax:201-836-1357
Practice Address - Street 1:878 QUEEN ANNE RD
Practice Address - Street 2:
Practice Address - City:TEANECK
Practice Address - State:NJ
Practice Address - Zip Code:07666-4623
Practice Address - Country:US
Practice Address - Phone:201-836-1776
Practice Address - Fax:201-836-1357
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-25
Last Update Date:2010-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR025403-11041C0700X
NJ44SCO45219001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical