Active NPI
Sydnie Kim Simmons, M.ED
- Clinical Psychologist
- Cadillac, MI
National Provider Identifier
1023363199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 6301015181
- Practice address
- 805 S Carmel St
Cadillac, MI 49601-2344 - Phone
- (231) 775-6517
- Fax
- (231) 775-6587
- NPI assigned
- Jul 16, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 6301015181 | MI | Primary |
Addresses
Primary practice location
805 S Carmel St
Cadillac, MI 49601-2344
Mailing address
805 S Carmel St
Cadillac, MI 49601-2344
Phone (231) 775-6517
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6301015181 | MI | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1342396800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1342396800000",
"number": "1023363199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "805 S CARMEL ST",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496012344",
"telephone_number": "231-775-6517",
"fax_number": "231-775-6587"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "805 S CARMEL ST",
"city": "CADILLAC",
"state": "MI",
"postal_code": "496012344",
"telephone_number": "231-775-6517",
"fax_number": "231-775-6587"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "SYDNIE",
"middle_name": "KIM",
"credential": "M.ED",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-16",
"last_updated": "2012-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MI",
"license": "6301015181",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cadillac, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.