Provider Demographics
NPI:1851442628
Name:JAMES SIMMERER, LCSW, COUNSELING & PSYCHOTHERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:JAMES SIMMERER, LCSW, COUNSELING & PSYCHOTHERAPY SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:SIMMERER
Authorized Official - Suffix:
Authorized Official - Credentials:MSW, LCSW
Authorized Official - Phone:708-228-0475
Mailing Address - Street 1:22W267 FIRST ST.
Mailing Address - Street 2:
Mailing Address - City:GLEN ELLYN
Mailing Address - State:IL
Mailing Address - Zip Code:60137-3530
Mailing Address - Country:US
Mailing Address - Phone:708-228-0475
Mailing Address - Fax:708-326-4095
Practice Address - Street 1:11309 DISTINCTIVE DR
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60467-9460
Practice Address - Country:US
Practice Address - Phone:708-228-0475
Practice Address - Fax:708-326-4095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILP33655Medicare UPIN