Mrs Mary Elizabeth Simmons, LPC | |
460 Langdon St, Spartanburg, SC 29302-1614 | |
(864) 582-2411 | |
(864) 582-7178 |
Full Name | Mrs Mary Elizabeth Simmons |
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Gender | Female |
Speciality | Counselor - Professional |
Location | 460 Langdon St, Spartanburg, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1710511886 | NPI | - | NPPES |
PC2281 | Medicaid | SC |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YP2500X | Counselor - Professional | 6474 (South Carolina) | Secondary |
101YP2500X | Counselor - Professional | 7532 (South Carolina) | Primary |
Entity Name | Regenesis Organization Community Health Center |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1457745952 PECOS PAC ID: 8022928001 Enrollment ID: O20170127000968 |
Mailing Address | Practice Location Address |
---|---|
Mrs Mary Elizabeth Simmons, LPC Po Box 5158, Spartanburg, SC 29304-5156 Ph: (864) 582-2411 | Mrs Mary Elizabeth Simmons, LPC 460 Langdon St, Spartanburg, SC 29302-1614 Ph: (864) 582-2411 |
Mr. Edmund Jackson Scott Jr., LMFT-I, CAC-P Counselor Medicare: Not Enrolled in Medicare Practice Location: 187 W Broad St Ste 200, Spartanburg, SC 29306 Phone: 864-707-2801 | |
Mrs. Katrina Hope Hereford, Counselor Medicare: Not Enrolled in Medicare Practice Location: 250 Dewey Ave, Spartanburg, SC 29303 Phone: 864-585-0366 | |
Jacquelyn Walker, Counselor Medicare: Not Enrolled in Medicare Practice Location: 460 Langdon St, Spartanburg, SC 29302 Phone: 864-549-0222 | |
Candace Soddu Quinn, LMSW Counselor Medicare: Not Enrolled in Medicare Practice Location: 129 Dillon Drive, Spartanburg, SC 29307 Phone: 864-582-7588 Fax: 864-562-4117 | |
Mark R. Anderson, Counselor Medicare: Not Enrolled in Medicare Practice Location: 324 E Saint John St, Spartanburg, SC 29302 Phone: 864-707-1953 | |
Mrs. Beverly B Shelton, CACII Counselor Medicare: Not Enrolled in Medicare Practice Location: 187 W Broad St, Spartanburg, SC 29306 Phone: 864-582-7588 Fax: 864-582-0431 | |
James Alva Young Jr., MA, CACP Counselor Medicare: Not Enrolled in Medicare Practice Location: 187 W Broad St, Spartanburg, SC 29306 Phone: 864-582-7588 Fax: 864-582-0431 |