Individual
MARK DANIEL SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCPC/C
Contact information
Practice address
103 WHITTEN HILL RD, KENNEBUNKPORT, ME 04046-5117
(207) 205-3708
Mailing address
103 WHITTEN HILL RD, KENNEBUNKPORT, ME 04046-5117
(207) 205-3708
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
XL4378
ME
101YM0800X
Mental Health Counselor
XL4378
ME
101YP2500X
Professional Counselor
Primary
XL4378
ME
Other
Enumeration date
05/13/2015
Last updated
05/13/2015
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