Individual
MR. KENNETH A SIMMONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
1825 SAINT JULIAN PL, COLUMBIA, SC 29204-2424
(803) 254-1210
Mailing address
1825 SAINT JULIAN PL, COLUMBIA, SC 29204-2424
(803) 254-1210
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
6713
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6713
—
SC
Enumeration date
06/09/2010
Last updated
06/09/2010
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