Provider Demographics
NPI:1598559817
Name:SIMMONS, SAVANNA (LMHC)
Entity type:Individual
Prefix:
First Name:SAVANNA
Middle Name:
Last Name:SIMMONS
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3169 ASHKIRK LOOP SE # NA
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87124-3614
Mailing Address - Country:US
Mailing Address - Phone:281-202-7207
Mailing Address - Fax:
Practice Address - Street 1:1424 DEBORAH RD SE STE 205
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87124-6619
Practice Address - Country:US
Practice Address - Phone:281-202-7207
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-09
Last Update Date:2025-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2025-0095101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health