Provider Demographics
NPI:1972264547
Name:SIMMONS, CASSEY ARI'
Entity type:Individual
Prefix:
First Name:CASSEY
Middle Name:ARI'
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:CASSEY
Other - Middle Name:ARI'
Other - Last Name:SIMMONS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:1700 NORTHSIDE DR
Mailing Address - Street 2:SUITE A7 #5207
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30318
Mailing Address - Country:US
Mailing Address - Phone:919-452-9877
Mailing Address - Fax:
Practice Address - Street 1:1700 NORTHSIDE DR
Practice Address - Street 2:SUITE A7 #5207
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30318
Practice Address - Country:US
Practice Address - Phone:919-452-9877
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-06
Last Update Date:2023-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACSW0078211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical