Individual
GINA MARIE SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPC,CAC III, MA
Contact information
Practice address
2956 GINNALA DR STE 205, LOVELAND, CO 80538-7825
(907) 599-1523
Mailing address
224 N SAINT LOUIS AVE, LOVELAND, CO 80537-5866
(970) 599-1523
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
ACC.0020880
CO
101YP2500X
Professional Counselor
Primary
LPC.0015178
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
EIN
COLORADO DEPARTMENT OF REGULATORY AGENCIES
CO
Enumeration date
06/15/2015
Last updated
01/25/2022
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