Individual
DR. GWEN S. SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ED.D., LPC, NBC, MAC
Contact information
Practice address
867 CASTLEBERRY CT, VASS, NC 28394-8306
(910) 245-2580
Mailing address
867 CASTLEBERRY CT, VASS, NC 28394-8306
(910) 245-2580
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CCAS 104
NC
101YP2500X
Professional Counselor
LPC 2013
NC
Other
Enumeration date
03/20/2007
Last updated
09/11/2025
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