| Doctor Name: | MR. PHILLIP SIMMONS |
| NPI Number: | 1386824670 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LLPC |
| License Number: | C-00782 |
| Business Practice Address: | 20490 Harper Ave Ste 113 Harper Woods, MI - 482251645 |
| Business Phone Number: | 3132316049 |
| Business Fax Number: | 3136408391 |
| Mailing Address: | 20490 Harper Ave Ste 113, HARPER WOODS |
| State: | MI |
| Postal Code: | 482251645 |
| Phone Number: | 3132316049 |
| Fax Number: | 3136408391 |
| NPI Enumeration Date: | 11/05/2007 |
| NPI Last Update Date: | 04/24/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | C-00782 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |