Healthcare Provider Details

I. General information

NPI: 1497668362
Provider Name (Legal Business Name): SIMONE G WORLEY LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2026
Last Update Date: 09/23/2026
Certification Date: 09/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

430 BLACKSTONE VLG
MERIDEN CT
06450-2409
US

IV. Provider business mailing address

430 BLACKSTONE VLG
MERIDEN CT
06450-2409
US

V. Phone/Fax

Practice location:
  • Phone: 551-666-2788
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number010189
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: