Provider Demographics
NPI:1578346128
Name:SIMMONS, TRUDY (LCPC)
Entity Type:Individual
Prefix:
First Name:TRUDY
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 DORRIS RD
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30004-3477
Mailing Address - Country:US
Mailing Address - Phone:404-803-0530
Mailing Address - Fax:
Practice Address - Street 1:600 ABBEY CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30004-6005
Practice Address - Country:US
Practice Address - Phone:404-803-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-17
Last Update Date:2023-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral