Provider Demographics
NPI:1134530918
Name:SIMMONS, JENNIFER L (MS, LMFT)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:L
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MS, LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N 26TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:IN
Mailing Address - Zip Code:47904-2856
Mailing Address - Country:US
Mailing Address - Phone:765-423-2638
Mailing Address - Fax:765-742-4196
Practice Address - Street 1:415 N 26TH ST STE 201
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:IN
Practice Address - Zip Code:47904-2856
Practice Address - Country:US
Practice Address - Phone:765-423-2638
Practice Address - Fax:765-742-4196
Is Sole Proprietor?:No
Enumeration Date:2014-05-14
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist