SAMUEL SIMMONS JR. (NPI# 1902281256) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902281256 |
| Entity Type | Individual |
| Full Name | SAMUEL SIMMONS JR. |
| Credential | LADC |
| Practice Address |
3442 25th Ave S Minneapolis MN 55406-2504 |
| Practice Telephone | 6127210106 |
| Mailing Telephone | 6127210106 |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
300322 | MN | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | LADC | 300322 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295811305 | Samuel Ray Simmons | Optometrist | 3411 N Anthony Blvd, Fort Wayne, IN 46805-2233 | 2006-10-31 |
| 1619305828 | Samuel Simmons | Physician Assistant | 1280 E Calvada Blvd, Pahrump, NV 89048-5693 | 2013-10-25 |
| 1891983680 | Samuel Simmons | Counselor | 2075 N Arrowhead Ave, San Bernardino, CA 92415-0001 | 2007-10-05 |
| 1972564649 | Samuel Curtis Simmons | Pharmacist | 1550 Tomcat Blvd, Virginia Beach, VA 23460-2218 | 2006-03-31 |
| Street Address |
3442 25TH AVE S |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55406-2504 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1689286221 | Hoa Bui | Pharmacist | 4547 Hiawatha, Minneapolis, MN 55406 | 2020-08-17 |
| 1184263253 | Carrie Shannon Nightshade | Acupuncturist | 3706 E 42nd Street, Minneapolis, MN 55406 | 2020-01-06 |
| 1164060059 | Deborah Owen | Acupuncturist | 3706 E 42nd St, Minneapolis, MN 55406 | 2019-12-11 |
| 1194290593 | Noelle Therese Wolf | Counselor | 2637 27th Ave S # 229, Minneapolis, MN 55406 | 2018-10-11 |
| 1255819819 | Ayan Osman Ali | Behavior Technician | 3355 Haiwatha Ave Suite 100, Minneapolis, MN 55406 | 2018-08-04 |
| 1881188597 | Lydia Joy Allison | Massage Therapist | 2933 29th Ave. S., Minneapolis, MN 55406 | 2018-06-15 |
| 1497261770 | Carroll Lee Beaty | Massage Therapist | 2801 42nd Ave. So., Minneapolis, MN 55406 | 2017-12-21 |
| 1578082798 | Capitol Cafe LLC | Home Delivered Meals | 2417 E Franklin Ave, Capitol Cafe, Minneapolis, MN 55406 | 2017-09-19 |
| 1851823942 | Safia Abdulkadir Mohamud | Contractor | 2740 Minnehaha Ave Suit 100, Minneapolis, MN 55406 | 2017-03-29 |
| 1881051944 | Sos Transportation LLC | Non-emergency Medical Transport (VAN) | 3355 Haiwatha Ave Suit 100, Minneapolis, MN 55406 | 2016-01-20 |
| Find all providers in zip 55406 | ||||
| Taxonomy Code | 101YA0400X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Addiction (Substance Use Disorder) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568062461 | Andrew Moe | Counselor | 2118 Blaisdell Ave S., Minneapolis, MN 55404 | 2020-10-29 |
| 1366056392 | Brianna Connor | Counselor | 2450 Riverside Ave Bldg Suite140, Minneapolis, MN 55454-1450 | 2020-09-08 |
| 1144831959 | Brian James Rose | Counselor | 5061 Lyndale Ave S, Minneapolis, MN 55419-1215 | 2020-08-14 |
| 1740891688 | Jennifer Twa | Counselor | 2104 Stevens Ave, Minneapolis, MN 55404-2533 | 2020-08-13 |
| 1568072254 | Marian Margaret Spiess | Counselor | 2200 1st Ave S, Minneapolis, MN 55404-3401 | 2020-08-06 |
| 1689201352 | Alyssa Mary Nyberg | Counselor | 2960 Winnetka Ave N Ste 1010, Minneapolis, MN 55427-2853 | 2020-03-24 |
| 1497392666 | Kristine Geraldine Hanson | Counselor | 2611 40th Ave S, Minneapolis, MN 55406-1862 | 2019-12-05 |
| 1265080501 | Carolyn J Niesche | Counselor | 2518 N 2nd St Ste 113, Minneapolis, MN 55411-2259 | 2019-08-29 |
| 1053966069 | Shane Jensen | Counselor | 610 22nd Ave S, Minneapolis, MN 55454-1315 | 2019-08-06 |
| 1114584760 | Lynn Marie Allar | Counselor | 2200 E Franklin Ave Ste 200a, Minneapolis, MN 55404-2395 | 2019-05-20 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55406 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.