Provider Demographics
NPI:1265265490
Name:GWEN SIMBECK LPC PLLC
Entity type:Organization
Organization Name:GWEN SIMBECK LPC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:GWEN
Authorized Official - Middle Name:EILEEN
Authorized Official - Last Name:SIMBECK
Authorized Official - Suffix:
Authorized Official - Credentials:MA, LPC
Authorized Official - Phone:719-481-6150
Mailing Address - Street 1:17840 GRAMA RDG
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80908-1363
Mailing Address - Country:US
Mailing Address - Phone:719-481-6150
Mailing Address - Fax:
Practice Address - Street 1:244 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONUMENT
Practice Address - State:CO
Practice Address - Zip Code:80132-9173
Practice Address - Country:US
Practice Address - Phone:719-481-6150
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-08-22
Last Update Date:2024-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)