Provider Demographics
NPI:1821531286
Name:SIMMONS, ADAM NICHOLAS
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:NICHOLAS
Last Name:SIMMONS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1382 HONODLE AVE
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44305-2778
Mailing Address - Country:US
Mailing Address - Phone:330-283-8533
Mailing Address - Fax:
Practice Address - Street 1:1382 HONODLE AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44305-2778
Practice Address - Country:US
Practice Address - Phone:330-283-8533
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-02
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst