Provider Demographics
NPI:1477001261
Name:SIMMS, BILAL (LCADC, CCS, MAC)
Entity Type:Individual
Prefix:MR
First Name:BILAL
Middle Name:
Last Name:SIMMS
Suffix:
Gender:M
Credentials:LCADC, CCS, MAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 STATE STREET
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07017
Mailing Address - Country:US
Mailing Address - Phone:862-224-0085
Mailing Address - Fax:
Practice Address - Street 1:60 STATE ST
Practice Address - Street 2:
Practice Address - City:EAST ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07017-1118
Practice Address - Country:US
Practice Address - Phone:862-224-0085
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-21
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00219200101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)