Kristie F Simmons, CSAC
Individual provider Active NPI Addiction (Substance Use Disorder) Counselor · Ellsworth, WI
NPI 1265722276 · NPPES record last updated Apr 11, 2011
Key facts
- NPI
- 1265722276
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Addiction (Substance Use Disorder) Counselor 101YA0400X
- License
- 15280-132 (WI)
- Practice address
- 412 W Kinne St
Ellsworth, WI 54011-9230 - Phone
- (715) 273-6770
- Fax
- (715) 273-6862
- NPI assigned
- Apr 11, 2011
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15280-132 | WI | MD | Addiction (Substance Use Disorder) Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 15280-132 | WI | Yes |
Addresses
Primary practice location
412 W Kinne St
Ellsworth, WI 54011-9230
Mailing address
412 W Kinne St
PO Box 670
Ellsworth, WI 54011-9230
Phone (715) 273-6770
Other providers in Ellsworth, WI
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- Krisan Shaw
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- Evangeline Desideria Sigwarth
- Barbara E Tashjian
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- Kimberly R Trebil
- Christina Treu
- Danielle Marie Turner
All providers in Ellsworth, WI · Addiction (Substance Use Disorder) Counselor in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 11, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.