Provider Demographics
NPI:1134885775
Name:SIMMONS, KATHERINE PAIGE (LMHC)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:PAIGE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 ASHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HUXLEY
Mailing Address - State:IA
Mailing Address - Zip Code:50124-9316
Mailing Address - Country:US
Mailing Address - Phone:309-751-7846
Mailing Address - Fax:
Practice Address - Street 1:5619 NW 86TH ST STE 500
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2955
Practice Address - Country:US
Practice Address - Phone:515-981-2848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2024-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA096392101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health