Simmons, Walter G
Simmons, Walter G is an sole proprietor health care provider with primary practice located at 325 King St 4C, Port Chester NY 10573-4050. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Simmons, Walter G can be contacted via phone (914) 937-9204.Contact Information
Primary practice address
325 King St 4C
Port Chester NY 10573-4050
Phone: (914) 937-9204
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 046310 | New York |
Profile Details
| NPI number | 1972640647 |
|---|---|
| LBN Legal business name | Simmons, Walter G |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 31st, 2007 |
| Last updated | Oct 16th, 2012 - about 13 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1972640647 | NPPES |
| New York | Other | A300056850 | MEDICARE PTAN |
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