Individual provider Active NPI

Hadley Mahan Simmonds, LPC

  • Professional Counselor
  • Nacogdoches, TX
National Provider Identifier
1083292981
Registry record updated Mar 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
81804 Issued in TX
Practice address
3824 N University Dr
Nacogdoches, TX 75965-2011
Phone
(936) 558-6200
NPI assigned
Mar 31, 2021
Last updated
Mar 31, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 81804 TX Primary

Addresses

Primary practice location

3824 N University Dr
Nacogdoches, TX 75965-2011

Mailing address

2410 Pearl St
Nacogdoches, TX 75965-3314
Phone (931) 636-8499

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231214003377 TX Practitioner - Mental Health Counselor 4385093491 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Burke CenterGroup PAC ID 1254312077, 28 clinicians

Practice addresses (Care Compare)

2001 S Medford Dr
Lufkin, TX 75901-6260
Phone (936) 633-5672

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
81804TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Burke Center CurrentSince Jan 1, 2024 Accepting new patients
Burke Center Past Accepting new patients

Locations

2001 S Medford Dr
Lufkin, TX 75901
Phone (936) 633-5672

3824 N University Dr
Nacogdoches, TX 75965
Phone (936) 558-6200

Organizations & group practices 2

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

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617148800000",
    "number": "1083292981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 PEARL ST",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759653314",
            "telephone_number": "931-636-8499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3824 N UNIVERSITY DR",
            "city": "NACOGDOCHES",
            "state": "TX",
            "postal_code": "759652011",
            "telephone_number": "936-558-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONDS",
        "first_name": "HADLEY",
        "middle_name": "MAHAN",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-03-31",
        "last_updated": "2021-03-31",
        "certification_date": "2021-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TX",
            "license": "81804",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nacogdoches, TX

Sources for this page

Verify at the official NPI Registry.