Provider Demographics
NPI:1629421680
Name:SIMMONDS, SHAAKIRA (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHAAKIRA
Middle Name:
Last Name:SIMMONDS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15905 LEE CARTER RD
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20155-2039
Mailing Address - Country:US
Mailing Address - Phone:954-445-2499
Mailing Address - Fax:
Practice Address - Street 1:15905 LEE CARTER RD
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:VA
Practice Address - Zip Code:20155-2039
Practice Address - Country:US
Practice Address - Phone:954-445-2499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-14
Last Update Date:2016-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040088641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical