Endia Dominique Simmons, CDCA

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CDCA.75276 Issued in OH

Practice address

1271 Crescent Hieghts Rd
Marion, OH 43302

Phone

(740) 360-8910

NPI assigned

Dec 22, 2020

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1608595200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608595200000",
    "number": "1871180018",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "527 E FAIRGROUND ST",
            "city": "MARION",
            "state": "OH",
            "postal_code": "433022639",
            "telephone_number": "740-360-8910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1271 CRESCENT HIEGHTS RD",
            "city": "MARION",
            "state": "OH",
            "postal_code": "43302",
            "telephone_number": "740-360-8910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "ENDIA",
        "middle_name": "DOMINIQUE",
        "credential": "CDCA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-22",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "CDCA.75276",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elliott D. Shuster
• Amy Marie Sieber, PHARMD
• Robin Ann Siefker, RN, BC, MSN
• Sigmund G Gagni DDS LLC
• Cindy Siler
• Dale Simpkins
• Dana Suzanne Simpson, LPN
• Parminder Bobby Singh, M.D.
• William P Sinnott, PA
• Megan Shea Slone

• Addiction (Substance Use Disorder) Counselor in Marion, OH
• Providers in Marion, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.