Provider Demographics
NPI:1679304885
Name:SIMMINS, CHIRSTOPHER R
Entity type:Individual
Prefix:
First Name:CHIRSTOPHER
Middle Name:R
Last Name:SIMMINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:50 N MAIN ST APT 101
Mailing Address - Street 2:
Mailing Address - City:HORNELL
Mailing Address - State:NY
Mailing Address - Zip Code:14843-1277
Mailing Address - Country:US
Mailing Address - Phone:865-801-2283
Mailing Address - Fax:
Practice Address - Street 1:4220 BOLIVAR RD
Practice Address - Street 2:
Practice Address - City:WELLSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14895-9332
Practice Address - Country:US
Practice Address - Phone:585-593-6300
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-09
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health