Provider Demographics
NPI:1356525463
Name:SIMMS, TERESA RENEE (LISW)
Entity type:Individual
Prefix:MS
First Name:TERESA
Middle Name:RENEE
Last Name:SIMMS
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 34TH ST
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50310-5245
Mailing Address - Country:US
Mailing Address - Phone:515-255-7758
Mailing Address - Fax:
Practice Address - Street 1:11333 AURORA AVE.
Practice Address - Street 2:IOWA HEALTH HOME CARE
Practice Address - City:URBANDALE
Practice Address - State:IA
Practice Address - Zip Code:50322
Practice Address - Country:US
Practice Address - Phone:515-557-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-26
Last Update Date:2007-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA016791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical