Provider Demographics
NPI:1427662535
Name:SIMMONS, JAMILIA MICHELLE (MSW, LCSWA)
Entity type:Individual
Prefix:
First Name:JAMILIA
Middle Name:MICHELLE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MSW, LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3383 HENDERSON DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-5231
Mailing Address - Country:US
Mailing Address - Phone:336-422-1157
Mailing Address - Fax:910-378-1363
Practice Address - Street 1:3383 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-5231
Practice Address - Country:US
Practice Address - Phone:252-439-0700
Practice Address - Fax:910-378-1363
Is Sole Proprietor?:No
Enumeration Date:2020-09-04
Last Update Date:2020-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0129491041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical