Individual
MELODIE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC, CEDS-S
Contact information
Practice address
2309 W LONG SHADOW TRL, PHOENIX, AZ 85085-6084
(623) 236-8631
Mailing address
2309 W LONG SHADOW TRL, PHOENIX, AZ 85085-6084
(623) 236-8631
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
16331
AZ
101YP2500X
Professional Counselor
Primary
LPC-16331
AZ
Other
Enumeration date
10/16/2020
Last updated
09/13/2021
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