Healthcare Provider Details

I. General information

NPI: 1972407567
Provider Name (Legal Business Name): LEIGH SIMONS LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2021 NEW RD STE 1
LINWOOD NJ
08221-1045
US

IV. Provider business mailing address

458 NAUTILUS DR
MANAHAWKIN NJ
08050-1635
US

V. Phone/Fax

Practice location:
  • Phone: 609-788-4698
  • Fax:
Mailing address:
  • Phone: 609-788-4698
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SL07420300
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: