Healthcare Provider Details

I. General information

NPI: 1003616863
Provider Name (Legal Business Name): STENIE SIMON LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/19/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

337 CRESSWELL RD
BALTIMORE MD
21225-3911
US

IV. Provider business mailing address

1443 ROCK SPRING RD STE 2008
BEL AIR MD
21014-1920
US

V. Phone/Fax

Practice location:
  • Phone: 774-444-7201
  • Fax:
Mailing address:
  • Phone: 410-417-7004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number30144
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: