Provider Demographics
NPI:1861015216
Name:SIMCOX, ANDREW MONTGOMERY X
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:MONTGOMERY
Last Name:SIMCOX
Suffix:X
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 1:1882 CREEK WOOD DR
Mailing Address - Street 2:
Mailing Address - City:DUBUQUE
Mailing Address - State:IA
Mailing Address - Zip Code:52003-7605
Mailing Address - Country:US
Mailing Address - Phone:563-231-3058
Mailing Address - Fax:
Practice Address - Street 1:UNIFIED COMMUNITY SERVICES
Practice Address - Street 2:200 WEST ALONA LANE
Practice Address - City:LANCASTER
Practice Address - State:WI
Practice Address - Zip Code:53813
Practice Address - Country:US
Practice Address - Phone:608-723-6357
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-20
Last Update Date:2020-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic