MEDICARE: SIMONE WILSON MSW, LLMSW, CAADC-DP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician
2	247200000X	Other Technician
3	1041C0700X	Clinical Social Worker	6801102161	MI

General Provider Information

NPI Number	:	1518317890
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE WILSON MSW, LLMSW, CAADC-DP

Provider Business Mailing Address
First Line	:	27300 FRANKLIN RD APT 720
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48034-2311
Country	:	US
Telephone Number	:	313-316-4440
Fax Number	:

Provider Business Practice Location Address
First Line	:	20411 W 12 MILE RD STE 101
Second Line	:
City	:	SOUTHFIELD
State	:	MI
Zip	:	48076-6404
Country	:	US
Telephone Number	:	866-703-1901
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/16/2016
Last Update Date	:	08/06/2019

Similar Medicare Providers

1528927167 — KIRSTEN HALE
Practice Location Address:

20411 W 12 MILE RD STE 101
SOUTHFIELD, MI
48076-6404

Practice Phone: 866-703-1901
Practice Fax:

1578561304 — MICHAEL GREGORY WILLIAMS MD
Practice Location Address:

20411 W 12 MILE RD STE 102
SOUTHFIELD, MI
48076-6404

Practice Phone: 248-905-3194
Practice Fax: 248-905-3548

1366636102 — DR. ELAINE BETH EPSTEIN PSYD, LP
Practice Location Address:

20411 W 12 MILE RD STE 101
SOUTHFIELD, MI
48076-6404

Practice Phone: 866-703-1901
Practice Fax: 866-703-1906

1386814077 — JAMES D KOHLER DDS PC
Practice Location Address:

20411 W 12 MILE , SUITE 102
SOUTHFIELD, MI
48076-6404

Practice Phone: 248-352-1110
Practice Fax: 248-352-0801

1265950752 — CAROLINE RENEE CALLAWAY MT-BC
Practice Location Address:

20411 W 12 MILE RD STE 101
SOUTHFIELD, MI
48076-6404

Practice Phone: 866-703-1901
Practice Fax:

1437710118 — ANDREA PEREZ MSW
Practice Location Address:

20411 W 12 MILE RD STE 101
SOUTHFIELD, MI
48076-6404

Practice Phone: 866-703-1901
Practice Fax:

Directions to “ SIMONE WILSON MSW, LLMSW, CAADC-DP” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.