Carol Ivy Simmons, PHD, LCSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10896 Issued in MD

Practice address

7103 A Antock Place
Upper Marlboro, MD 20772

Phone

(240) 350-6377

NPI assigned

Mar 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Safe Harbor Behavioral Care, LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1316487879
  NPD
• Safe Harbor Christian Counseling LLC

  • Clinical Social Worker
  • Bel Air, MD
  • NPI 1245377894
  NPD
• Arundel Mental Health Professionals LLC

  • Clinical Psychologist
  • Crofton, MD
  • NPI 1497481246
  NPD (past)
• Peoples Community Health Center, Inc

  • Community Health Clinic/Center
  • Baltimore, MD
  • NPI 1083905749
  NPD (past)
• Peoples Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Severn, MD
  • NPI 1912976796
  NPD (past)

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

{
    "created_epoch": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1659340057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 1337",
            "city": "GALLUP",
            "state": "NM",
            "postal_code": "873051337",
            "telephone_number": "505-722-1000",
            "fax_number": "505-726-8557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7103 A ANTOCK PLACE",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "20772",
            "telephone_number": "240-350-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "CAROL",
        "middle_name": "IVY",
        "name_prefix": "Dr.",
        "credential": "PHD, LCSW-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2021-06-03",
        "certification_date": "2021-05-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "10896",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7103 A Antock Place",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20772",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepiceast.kp.org:14430/Interconnect-prodmam/wcf/epic.community.hie/xcpdrespondinggateways",
            "affiliation": "N",
            "endpointDescription": "Carequality",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7103 A Antock Place",
            "city": "Upper Marlboro",
            "state": "MD",
            "country_code": "US",
            "postal_code": "20772",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Destiny Shuri, DS
• Eric Armand Siewe
• Darlene Natalie Silver, MSN, IBCLC
• Kimberly Silver
• Simky Family & Healthcare Services
• Jennifer Simmons, LCSW
• Brittany Simms, LGPC
• Erica D Simms, DDS
• Venita Simon, OTD, OTR/L, SLP-CCC
• Simple Health Care LLC

• Clinical Social Worker in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Clinical Social Worker in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.