Active NPI
Phillip Simmons, LLPC
- Professional Counselor
- Harper Woods, MI
National Provider Identifier
1386824670
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 6401009795
- Practice address
- 20490 Harper Ave Ste 113
Harper Woods, MI 48225-1645 - Phone
- (313) 231-6049
- Fax
- (313) 640-8391
- NPI assigned
- Nov 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 6401009795 | MI | Primary |
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | C-00782 | MI |
Addresses
Primary practice location
20490 Harper Ave Ste 113
Harper Woods, MI 48225-1645
Mailing address
20490 Harper Ave Ste 113
Harper Woods, MI 48225-1645
Phone (313) 231-6049
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C-00782 | MI | MD | Addiction (Substance Use Disorder) Counselor |
| 6401009795 | MI | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Strategies of Lifr Outreach Ministry Church | Past | Accepting new patients | |
| Pure Recovery Inc. | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Substance Abuse Rehabilitation Facility
- Detroit, MI
- NPI 1861778680
-
- Voluntary or Charitable Agency
- Detroit, MI
- NPI 1285960260
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1194220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1208995200000",
"number": "1386824670",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20490 HARPER AVE STE 113",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482251645",
"telephone_number": "313-231-6049",
"fax_number": "313-640-8391"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20490 HARPER AVE STE 113",
"city": "HARPER WOODS",
"state": "MI",
"postal_code": "482251645",
"telephone_number": "313-231-6049",
"fax_number": "313-640-8391"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMMONS",
"first_name": "PHILLIP",
"name_prefix": "Mr.",
"credential": "LLPC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-11-05",
"last_updated": "2008-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MI",
"license": "6401009795",
"primary": true
},
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "MI",
"license": "C-00782",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harper Woods, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.