Madelyn Simmons

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

PC016317 Issued in PA

Practice address

3800 W 12TH St Ste 7
Erie, PA 16505-3380

Phone

(814) 482-2209

NPI assigned

Oct 27, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Previously, effective Sep 5, 2024 through Sep 5, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Diverge Counseling LLC

  dba Diverge Counseling and Connection

  • Counselor
  • Erie, PA
  • NPI 1689409955
  NPD Authorized official
• Forest Counseling, LLC

  • Adolescent and Children Mental Health Clinic/Center
  • Erie, PA
  • NPI 1619563004
  NPD

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

{
    "created_epoch": "1698364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698364800000",
    "number": "1285406645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4406 BRANDES ST",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165042318",
            "telephone_number": "610-737-9507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3800 W 12TH ST STE 7",
            "city": "ERIE",
            "state": "PA",
            "postal_code": "165053380",
            "telephone_number": "814-482-2209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MADELYN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-27",
        "last_updated": "2023-10-27",
        "certification_date": "2023-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "PA",
            "license": "PC016317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hridyesh Sikri, M.D.
• Joelle M Silvestri, PA-S
• Aundrea L. Simko, CRNA
• Shawn M Simko, DO
• Suni Simmonds, PHARMD, RPH
• Matthew E Simmons, DDS
• Sue A. Simmons, CRNA
• Andrew Simon-Wambach, ATC
• Hannah Lynn Simon, PA-C
• Lee J Simon, DDS

• Mental Health Counselor in Erie, PA
• Providers in Erie, PA by specialty
• Mental Health Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.