Provider Demographics
NPI:1992999684
Name:SIMMS, JANELLE LYNN (LIMHP, LMHP)
Entity type:Individual
Prefix:MS
First Name:JANELLE
Middle Name:LYNN
Last Name:SIMMS
Suffix:
Gender:F
Credentials:LIMHP, LMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6112
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68106-0112
Mailing Address - Country:US
Mailing Address - Phone:402-208-5953
Mailing Address - Fax:402-614-9947
Practice Address - Street 1:1941 S 42ND ST
Practice Address - Street 2:SUITE 129
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68105-2939
Practice Address - Country:US
Practice Address - Phone:402-208-5953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-05
Last Update Date:2015-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE8303101YM0800X
NE1329101YM0800X
NE3766101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE10025885000Medicaid