Willie Simmons

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

License

20930 Issued in MD

Legal business name

WILLIE SIMMONS

Practice address

12500 Clearwater Way
Upper Marlboro, MD 20772-6600

Phone

(240) 432-9338

NPI assigned

Sep 22, 2015

Organization subpart

No

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

Authorized official

Name

Mr. Willie A Simmons, LICSWC

Title

Mr.

Phone

(240) 432-9338

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1442880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1442880000000",
    "number": "1699144402",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12500 CLEARWATER WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207726600",
            "telephone_number": "240-432-9338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12500 CLEARWATER WAY",
            "city": "UPPER MARLBORO",
            "state": "MD",
            "postal_code": "207726600",
            "telephone_number": "240-432-9338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLIE SIMMONS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-22",
        "last_updated": "2015-09-22",
        "status": "A",
        "authorized_official_last_name": "SIMMONS",
        "authorized_official_first_name": "WILLIE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "MR.",
        "authorized_official_telephone_number": "240-432-9338",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LICSWC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "MD",
            "license": "20930",
            "primary": true
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "DC",
            "license": "LC50079182",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Renardis E Williams, LICSW
• Severina Williams
• Tiara Williams, LMSW
• Tiffany Williams, LPC
• Joni Lachelle Williamson-Turner, PSYD, IBCLC
• Wills Medical Group PC
• John Herman Wills, M.D.
• Charles H Wilson IV, LMHP-R
• Jeanine Michelle Wilson, LICSW
• Jennifer Joann Wilson, DDS

• Community/Behavioral Health Agency in Upper Marlboro, MD
• Providers in Upper Marlboro, MD by specialty
• Community/Behavioral Health Agency in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.