MRS. NIKISHA LYNNETTE SIMMONS-MACLIN LADC
NPI 1063870905
Counselor - Addiction (Substance Use Disorder) in Coon Rapids, MN

Q: What is Nikisha Simmons-maclin's NPI number?

The NPI number for Nikisha Simmons-maclin is 1063870905. It was assigned to this individual provider in the NPPES registry on February 6, 2016.

Q: What is Nikisha Simmons-maclin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Active since February 06, 2016

10026 UNIVERSITY AVE NW STE 103, COON RAPIDS, MN 55448(612) 636-9677 Get Directions Write a Review

NPPES record last updated: January 30, 2019. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jan 30, 2019, Feb 6, 2016 (2 updates tracked since 2016).

On this page

About Mrs. Nikisha Lynnette Simmons-maclin Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. NIKISHA LYNNETTE SIMMONS-MACLIN LADC (NPI 1063870905) is an individual addiction (substance use disorder) provider in Coon Rapids, Minnesota, licensed in Minnesota (304191) and active in the NPI registry since February 2016. She maintains a secondary practice location in Brooklyn Park.

NPPES Registry Identity

NPI1063870905

Entity TypeIndividualFemale

Primary Taxonomy101YA0400X

Provider Legal NameMRS. NIKISHA LYNNETTE SIMMONS-MACLINCredential: LADC

Location Address10026 UNIVERSITY AVE NW STE 103Coon Rapids, MN 55448-2213

Mailing Address10732 Ilex St NwCoon Rapids, MN 55448-6508 · (612) 636-9677

Phone(612) 636-9677

Sole ProprietorYes

Enumeration DateFebruary 6, 2016

Last NPPES UpdateJanuary 30, 20192 updates tracked since enumeration

✔ NPI 1063870905 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

License✔ Licensed in MN · 304191

10026 UNIVERSITY AVE NW STE 103, Coon Rapids, MN 55448

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Secondary Practice Location 1

Location 18557 Wyoming Ave N Ste 6Brooklyn Park, MN 55445-1847 · Phone (612) 636-9677

Other Identifiers 2

Other304191MN · Minnesota Board Of Behavior Health

Other1098948MN · Minnesota Department Of Human Services

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RENEWED LIFE COUNSELING, LLC

Substance Abuse Rehabilitation Facility

10026 UNIVERSITY AVE NW STE 103
COON RAPIDS, MN 55448

Anoka County (612) 636-9677

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Nikisha Simmons-maclin's NPI number?

The NPI number for Nikisha Simmons-maclin is 1063870905. It was assigned to this individual provider in the NPPES registry on February 6, 2016.

Where is Nikisha Simmons-maclin located?

Nikisha Simmons-maclin practices at 10026 University Ave NW Ste 103, Coon Rapids, MN 55448. The listed phone number is (612) 636-9677.

What is Nikisha Simmons-maclin's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

When was this NPI record last updated?

The NPPES record for Nikisha Simmons-maclin was last updated on January 30, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.