Provider Demographics
NPI:1407996952
Name:SIMMONS, ROSALIE MCGRANE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:ROSALIE
Middle Name:MCGRANE
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 1:195 FLICK DR
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-8827
Mailing Address - Country:US
Mailing Address - Phone:828-964-9338
Mailing Address - Fax:
Practice Address - Street 1:195 FLICK DR
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-8827
Practice Address - Country:US
Practice Address - Phone:828-964-9338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5142101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional