Provider Demographics
NPI:1912927575
Name:SIMMONS, LINDA LEA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:LEA
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2900 SW 13TH ST
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-3800
Mailing Address - Country:US
Mailing Address - Phone:816-516-7114
Mailing Address - Fax:
Practice Address - Street 1:2900 SW 13TH ST
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-3800
Practice Address - Country:US
Practice Address - Phone:816-516-7114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2016-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7923103TC0700X
MO2006036657103TC0700X
AR00-08P103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical