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Individual

BRIAN MARC SIMMONS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
2131 KIRKWOOD BLVD, SOUTHLAKE, TX 76092-1529
(214) 226-4206
(817) 402-2437
Mailing address
7 STRAIGHT CREEK CT, TROPHY CLUB, TX 76262-5440
(214) 226-4206

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
69257
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
69257
COUNSELING LICENSE
TX
Enumeration date
09/17/2019
Last updated
09/17/2019
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