Individual provider Active NPI

Terri Simmons, LPCC-S

  • Counselor
  • Canton, OH
National Provider Identifier
1477794006
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
E.0600072-SUPV Issued in OH
Practice address
4809 Munson St NW
Canton, OH 44718-3614
Phone
(330) 705-0730
NPI assigned
Mar 11, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X RJ982926 OH
Counselor 101Y00000X E.0600072-SUPV OH Primary

Addresses

Primary practice location

4809 Munson St NW
Canton, OH 44718-3614

Mailing address

4809 Munson St NW
Canton, OH 44718-3614
Phone (330) 705-0730

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20240708001800 OH Practitioner - Mental Health Counselor 9537603121 Reassigns benefits to 1 organization
Practice locations: Canton, OH

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RJ982926OHMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Terri L Simmons CurrentSince Dec 18, 2024 Accepting new patients

Locations

4809 Munson St NW
Canton, OH 44718
Phone (330) 705-0370

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1236729600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697068800000",
    "number": "1477794006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4809 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183614",
            "telephone_number": "330-705-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4809 MUNSON ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447183614",
            "telephone_number": "330-705-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "TERRI",
        "credential": "LPCC-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-03-11",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "RJ982926",
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OH",
            "license": "E.0600072-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.