Provider Demographics
NPI:1336266691
Name:SIMMONS-COLE, STEPHANIE DYANE (LPC)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:DYANE
Last Name:SIMMONS-COLE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:270 CHARLESTON PKWY
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:GA
Mailing Address - Zip Code:30157-8922
Mailing Address - Country:US
Mailing Address - Phone:404-314-4671
Mailing Address - Fax:770-830-7149
Practice Address - Street 1:100 PROFESSIONAL PL
Practice Address - Street 2:SUITE 104
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3874
Practice Address - Country:US
Practice Address - Phone:770-830-7039
Practice Address - Fax:770-830-7149
Is Sole Proprietor?:No
Enumeration Date:2007-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC004531101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional