Individual
MARY HARRIET SIMMS-BOONE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
3345 HWY 208, LEBANON, KY 40033-9487
(844) 435-0900
(270) 858-4029
Mailing address
PO BOX 1080, BURKESVILLE, KY 42717-1080
(270) 858-6655
(270) 858-4027
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1237
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
115588460
CAQH
KY
05
—
7100268860
—
KY
Enumeration date
07/31/2006
Last updated
09/13/2024
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