person
Mrs. Nikisha Lynnette Simmons-maclin, LADC
Addiction (Substance Use Disorder) Counselor in Coon Rapids, Minnesota
NPI 1063870905

Nikisha Lynnette Simmons-maclin is an Addiction (Substance Use Disorder) Counselor based in Coon Rapids, MN and is specialized in Addiction (Substance Use Disorder). Nikisha Lynnette Simmons-maclin practices in Coon Rapids, MN and has the professional credentials of LADC. The NPI Number for Nikisha Lynnette Simmons-maclin is 1063870905 and holds a License No. 304191 (Minnesota).

The current practice location address for Nikisha Lynnette Simmons-maclin is 10026 University Ave Nw Ste 103, Coon Rapids, MN and can be reached out via phone at 612-636-9677. You can also correspond with Nikisha Lynnette Simmons-maclin through the mailing address at 10732 ILEX ST NW, COON RAPIDS, MN - 55448-6508 (mailing address contact number: 612-636-9677).

Location: 10026 University Ave Nw Ste 103, Coon Rapids, MN, 55448-6508
person
Provider Profile Details
NPI Number
1063870905
Provider Name
Nikisha Lynnette Simmons-maclin
Credential
LADC
Provider Entity Type
Individual
Gender
Female
Address
10026 University Ave Nw Ste 103, Coon Rapids, MN, 55448-6508
Phone Number
612-636-9677
Fax Number
Provider Enumeration Date
02/06/2016
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1098948 01 MN MINNESOTA DEPARTMENT OF HUMAN SERVICES
304191 01 MN MINNESOTA BOARD OF BEHAVIOR HEALTH
institution
Provider Business Practice Location Address Details
Address
10026 University Ave Nw Ste 103
City
State
Zip
55448-2213
Phone Number
612-636-9677
Fax Number
person
Provider Business Mailing Address Details
Address
10732 Ilex St Nw
City
State
Zip
55448-6508
Phone Number
612-636-9677
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
304191 (Minnesota)
Definition
Definition to come...
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