Provider Demographics
NPI:1215342274
Name:SIMMONS, CHARLES LEE JR (LPC, NCC, CACII)
Entity type:Individual
Prefix:
First Name:CHARLES
Middle Name:LEE
Last Name:SIMMONS
Suffix:JR
Gender:M
Credentials:LPC, NCC, CACII
Other - Prefix:
Other - First Name:CHAZ
Other - Middle Name:
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1905 W 8TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:CO
Mailing Address - Zip Code:80537-5295
Mailing Address - Country:US
Mailing Address - Phone:970-599-1440
Mailing Address - Fax:970-797-1393
Practice Address - Street 1:1905 W 8TH ST STE 202
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80537
Practice Address - Country:US
Practice Address - Phone:970-599-1440
Practice Address - Fax:970-797-1393
Is Sole Proprietor?:No
Enumeration Date:2014-06-27
Last Update Date:2019-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACB.0007896101YA0400X
COLPC.0015242101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)