Provider Demographics
NPI:1457844649
Name:SIMMS, MICHAEL WILSON (LCSW, LAC, ADS)
Entity type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:WILSON
Last Name:SIMMS
Suffix:
Gender:M
Credentials:LCSW, LAC, ADS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17095 E 105TH AVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE CITY
Mailing Address - State:CO
Mailing Address - Zip Code:80022-0570
Mailing Address - Country:US
Mailing Address - Phone:720-656-5571
Mailing Address - Fax:
Practice Address - Street 1:90 MADISON ST STE 308
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80206-5412
Practice Address - Country:US
Practice Address - Phone:720-656-5571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-12
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COACD.0001089101YA0400X
COCSW.09926662101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health