Basic Information
| Provider Information | |||||||||
| NPI: | 1215261003 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SIMMONS | ||||||||
| FirstName: | LEROY | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | LMSW | ||||||||
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| Mailing Information | |||||||||
| Address1: | 130 GLENWOOD AVE | ||||||||
| Address2: | UNIT 8 | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107032649 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3477490927 | ||||||||
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| Practice Location | |||||||||
| Address1: | 107 S BROADWAY | ||||||||
| Address2: | C/O SAINT JOSEPH'S MEDICAL CENTER | ||||||||
| City: | YONKERS | ||||||||
| State: | NY | ||||||||
| PostalCode: | 107014006 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9143787000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 09/25/2009 | ||||||||
| LastUpdateDate: | 06/27/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 088951 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.