Provider Demographics
NPI:1023438132
Name:SIMONS, KAY SUE (LCSW)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:SUE
Last Name:SIMONS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:SUE
Other - Last Name:DELOACH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:356 E 6990 S
Mailing Address - Street 2:
Mailing Address - City:MIDVALE
Mailing Address - State:UT
Mailing Address - Zip Code:84047-1641
Mailing Address - Country:US
Mailing Address - Phone:801-400-9378
Mailing Address - Fax:
Practice Address - Street 1:356 E 6990 S
Practice Address - Street 2:
Practice Address - City:MIDVALE
Practice Address - State:UT
Practice Address - Zip Code:84047-1641
Practice Address - Country:US
Practice Address - Phone:801-400-9378
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6262134-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical