Kimberly Simmons, QBHP

Individual provider Active NPI Case Manager/Care Coordinator · Mammoth Spring, AR

NPI 1053072256 · NPPES record last updated Jan 10, 2022

Key facts

NPI
1053072256
Entity type
Individual (NPI type 1)
Primary specialty
Case Manager/Care Coordinator 171M00000X
Practice address
1355 Tate Ave
Mammoth Spring, AR 72554-8064
Phone
(870) 625-0273
Fax
(870) 625-0275
NPI assigned
Jan 10, 2022
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Transforming Lives Counseling LLC Current
since Jan 21, 2022
Accepting new patients

Locations

1355 Tate Ave
Mammoth Spring, AR 72554
Phone (870) 625-0273

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Case Manager/Care Coordinator 171M00000X Yes

Addresses

Primary practice location

1355 Tate Ave
Mammoth Spring, AR 72554-8064

Mailing address

PO Box 1134
Mammoth Spring, AR 72554-1134
Phone (870) 625-0273

Other providers in Mammoth Spring, AR

All providers in Mammoth Spring, AR · Case Manager/Care Coordinator in Arkansas

Sources for this page

Verify at the official NPI Registry.