Vanessa Simmons, | |
333 Revolutionary Trl, Fairfax, SC 29827-7109 | |
(803) 632-2533 | |
(803) 632-3285 |
Full Name | Vanessa Simmons |
---|---|
Gender | Female |
Speciality | Counselor |
Location | 333 Revolutionary Trl, Fairfax, 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 |
---|---|---|---|
1396149340 | NPI | - | NPPES |
AD01AK | Medicaid | SC | |
6524 | Other | SC | MEDICAL LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
101YA0400X | Counselor - Addiction (substance Use Disorder) | 6524 (South Carolina) | Secondary |
101Y00000X | Counselor | 6524 (South Carolina) | Primary |
Entity Name | Low Country Health Care System Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1053475566 PECOS PAC ID: 4284530940 Enrollment ID: O20031211000944 |
Mailing Address | Practice Location Address |
---|---|
Vanessa Simmons, 86 Wren St, Barnwell, SC 29812-1529 Ph: (803) 259-5762 | Vanessa Simmons, 333 Revolutionary Trl, Fairfax, SC 29827-7109 Ph: (803) 632-2533 |
Sandra Lee Washington Bennett, MA, APC Counselor Medicare: Not Enrolled in Medicare Practice Location: 168 14th Street, Fairfax, SC 29827 Phone: 843-301-3470 | |
Ms. Myecha Lashawn Miley, Counselor Medicare: Not Enrolled in Medicare Practice Location: 364 14th St W, Fairfax, SC 29827 Phone: 803-571-6627 | |
Ms. Shenika L. Marshall-hill, Counselor Medicare: Not Enrolled in Medicare Practice Location: 1594 Beaufort Ave. S., Fairfax, SC 29827 Phone: 803-632-2039 |