Provider Demographics
NPI:1053010629
Name:SIMMS, LISA BETH
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:BETH
Last Name:SIMMS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:273 SKIDMORE LN
Mailing Address - Street 2:
Mailing Address - City:SUTTON
Mailing Address - State:WV
Mailing Address - Zip Code:26601-9272
Mailing Address - Country:US
Mailing Address - Phone:304-765-4400
Mailing Address - Fax:
Practice Address - Street 1:273 SKIDMORE LN
Practice Address - Street 2:
Practice Address - City:SUTTON
Practice Address - State:WV
Practice Address - Zip Code:26601-9272
Practice Address - Country:US
Practice Address - Phone:304-765-4400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-02
Last Update Date:2023-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist