Provider Demographics
NPI:1548999113
Name:SIMMONS, ASHLEY SHAKIRIE (MSW, LISW-CP)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:SHAKIRIE
Last Name:SIMMONS
Suffix:
Gender:F
Credentials:MSW, LISW-CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:365 HAMILTON PKWY
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29642-3039
Mailing Address - Country:US
Mailing Address - Phone:864-506-3202
Mailing Address - Fax:
Practice Address - Street 1:430 WOODRUFF RD STE 450
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-3443
Practice Address - Country:US
Practice Address - Phone:864-400-5130
Practice Address - Fax:864-818-4697
Is Sole Proprietor?:No
Enumeration Date:2022-06-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC14439104100000X
SC166791041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker