| Angela Simmons Llc | |
|
130 Kings Daughters Dr Frankfort KY 40601-4248 | |
| (502) 219-7762 | |
| (502) 223-7491 |
| Full Name | Angela Simmons Llc |
|---|---|
| Speciality | Social Worker |
| Location | 130 Kings Daughters Dr, Frankfort, Kentucky |
| Authorized Official Name and Position | Angela Dw Simmons (PROVIDER/OWNER) |
| Authorized Official Contact | 8598050188 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Angela Simmons Llc 209 Cardinal Ave Versailles KY 40383-1113 Ph: (859) 805-0188 | Angela Simmons Llc 130 Kings Daughters Dr Frankfort KY 40601-4248 Ph: (502) 219-7762 |
| NPI Number | 1669985800 |
|---|---|
| Provider Enumeration Date | 11/09/2017 |
| Last Update Date | 11/06/2020 |
| Certification Date | 11/06/2020 |
| Medicare PECOS PAC ID | 4284991431 |
|---|---|
| Medicare Enrollment ID | O20171127002147 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669985800 | NPI | - | NPPES |
| 7100628820 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 1106 (Kentucky) | Primary |
| Provider Name | Angela Dawn Weakley Simmons |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578942256 PECOS PAC ID: 7517271497 Enrollment ID: I20171219002045 |
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