Healthcare Provider Details

I. General information

NPI: 1558051714
Provider Name (Legal Business Name): JULIE KAY SIMON LMSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2023
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 N FRANKLIN ST
MT PLEASANT MI
48858-2303
US

IV. Provider business mailing address

5846 10TH AVE
BLANCHARD MI
49310-9606
US

V. Phone/Fax

Practice location:
  • Phone: 989-854-0139
  • Fax:
Mailing address:
  • Phone: 989-854-0139
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6801122405
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: