Provider Demographics
NPI:1881299303
Name:SIMMONS, ABIGAIL JOY (LMSW)
Entity type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JOY
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9760 BINGHAM ST
Mailing Address - Street 2:
Mailing Address - City:ZEELAND
Mailing Address - State:MI
Mailing Address - Zip Code:49464-9540
Mailing Address - Country:US
Mailing Address - Phone:616-566-5157
Mailing Address - Fax:
Practice Address - Street 1:9760 BINGHAM ST
Practice Address - Street 2:
Practice Address - City:ZEELAND
Practice Address - State:MI
Practice Address - Zip Code:49464-9540
Practice Address - Country:US
Practice Address - Phone:616-566-5157
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-12-02
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6801097193104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker