Provider Demographics
NPI:1891551453
Name:LIZA SIMRELL, LLC
Entity Type:Organization
Organization Name:LIZA SIMRELL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LIZA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMRELL
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC-S
Authorized Official - Phone:567-694-5944
Mailing Address - Street 1:7849 HAWKINS CT
Mailing Address - Street 2:
Mailing Address - City:SYLVANIA
Mailing Address - State:OH
Mailing Address - Zip Code:43560-9243
Mailing Address - Country:US
Mailing Address - Phone:419-304-3828
Mailing Address - Fax:
Practice Address - Street 1:5749 PARK CENTER CT
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43615-1479
Practice Address - Country:US
Practice Address - Phone:567-694-5944
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-22
Last Update Date:2024-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Multi-Specialty