Provider Demographics
NPI: | 1124579339 |
---|---|
Name: | SIMMS INTEGRATIVE HEALTH SERVICES INC |
Entity type: | Organization |
Organization Name: | SIMMS INTEGRATIVE HEALTH SERVICES INC |
Other - Org Name: | |
Other - Org Type: | |
Authorized Official - Title/Position: | OWNER |
Authorized Official - Prefix: | |
Authorized Official - First Name: | MEGAN |
Authorized Official - Middle Name: | |
Authorized Official - Last Name: | SIMMS |
Authorized Official - Suffix: | |
Authorized Official - Credentials: | |
Authorized Official - Phone: | 304-261-8456 |
Mailing Address - Street 1: | 312 W KING ST |
Mailing Address - Street 2: | |
Mailing Address - City: | MARTINSBURG |
Mailing Address - State: | WV |
Mailing Address - Zip Code: | 25401-3202 |
Mailing Address - Country: | US |
Mailing Address - Phone: | |
Mailing Address - Fax: | |
Practice Address - Street 1: | 312 W KING ST |
Practice Address - Street 2: | |
Practice Address - City: | MARTINSBURG |
Practice Address - State: | WV |
Practice Address - Zip Code: | 25401-3202 |
Practice Address - Country: | US |
Practice Address - Phone: | 304-261-8456 |
Practice Address - Fax: | |
EIN: | <UNAVAIL> |
Is Organization Subpart?: | No |
Parent Organization LBN: | |
Parent Organization TIN: | |
Enumeration Date: | 2016-10-24 |
Last Update Date: | 2020-08-24 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
WV | DP00944131 | 1041C0700X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 1041C0700X | Behavioral Health & Social Service Providers | Social Worker | Clinical | Group - Multi-Specialty |