Bryan Nicholas Simmon, M.A., LPC

Individual provider Active NPI Professional Counselor · Johnsburg, IL

NPI 1124358585 · NPPES record last updated Jan 7, 2010

Key facts

NPI
1124358585
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
178.006445 (IL)
Practice address
3510 Chapel Hill Rd
Johnsburg, IL 60051-2506
Phone
(877) 375-3484
NPI assigned
Jan 7, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
178.006445ILMDProfessional Counselor

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 178.006445 IL Yes

Addresses

Primary practice location

3510 Chapel Hill Rd
Johnsburg, IL 60051-2506

Mailing address

3510 Chapel Hill Rd
Johnsburg, IL 60051-2506
Phone (877) 375-3484

Other providers in Johnsburg, IL

All providers in Johnsburg, IL · Professional Counselor in Illinois

Sources for this page

Verify at the official NPI Registry.