Provider Demographics
NPI:1942375142
Name:SIMMONS, MICHELLE RENEE (LPC)
Entity Type:Individual
Prefix:MISS
First Name:MICHELLE
Middle Name:RENEE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:994 S ZENO WAY
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80017-3393
Mailing Address - Country:US
Mailing Address - Phone:303-898-6994
Mailing Address - Fax:303-898-6994
Practice Address - Street 1:3280 DOWNING ST
Practice Address - Street 2:SUITE A
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80205-3994
Practice Address - Country:US
Practice Address - Phone:303-225-2705
Practice Address - Fax:303-898-6994
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2992101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional