Individual
PORTIA SIMMONS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 BAINBRIDGE DR, CHARLESTON, SC 29407-4240
(843) 709-7356
Mailing address
17 BAINBRIDGE DR, CHARLESTON, SC 29407-4240
(843) 709-7356
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
COU.10506
SC
171400000X
Health & Wellness Coach
Primary
COU.10506
SC
171M00000X
Case Manager/Care Coordinator
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Other
Enumeration date
03/03/2019
Last updated
12/02/2025
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