Provider Demographics
NPI:1710493432
Name:SIMMONS, ASHLYN G (LMSW)
Entity Type:Individual
Prefix:
First Name:ASHLYN
Middle Name:G
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:ASHLYN
Other - Middle Name:
Other - Last Name:KUBACAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:300 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64111-1410
Mailing Address - Country:US
Mailing Address - Phone:816-508-3569
Mailing Address - Fax:816-508-1757
Practice Address - Street 1:421 E 137TH ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64145
Practice Address - Country:US
Practice Address - Phone:816-508-3600
Practice Address - Fax:816-508-3797
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS10724104100000X
MO2018000140104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker