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NPI Code Detail

MEDICARE: STEPHANIE ANNA SIMONSON MSW, LCSW

MEDICARE: STEPHANIE ANNA SIMONSON MSW, LCSW
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
1104100000XSocial Worker1109-122WI
21041C0700XClinical Social Worker11318-123WI

General Provider Information

NPI Number : 1780391250
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ANNA SIMONSON MSW, LCSW
Provider Business Mailing Address
First Line : 201 W GROVE ST
Second Line :
City : ALMA CENTER
State : WI
Zip : 54611-9770
Country : US
Telephone Number : 608-807-9183
Fax Number :
Provider Business Practice Location Address
First Line : 517 COURT ST
Second Line :
City : NEILLSVILLE
State : WI
Zip : 54456-1971
Country : US
Telephone Number : 715-743-5233
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2022
Last Update Date : 06/22/2023

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