Individual
BRENDA JUNE FITZ-SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW, CADC1, SAP
Contact information
Practice address
909 S 2ND ST, HIAWATHA, KS 66434-2774
(785) 742-7113
(785) 742-3085
Mailing address
110 N THOMPSON ST, PRATT, KS 67124-1801
(620) 672-3812
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
CADC1
KS
101YA0400X
Addiction (Substance Use Disorder) Counselor
SAP
KS
104100000X
Social Worker
Primary
4166 LMSW
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200434090A
—
KS
Enumeration date
08/20/2006
Last updated
03/30/2011
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