Healthcare Provider Details

I. General information

NPI: 1699638478
Provider Name (Legal Business Name): SIMONE LES
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

93 WYCKOFF AVE APT 1A
BROOKLYN NY
11237-2988
US

IV. Provider business mailing address

93 WYCKOFF AVE APT 1A
BROOKLYN NY
11237-2988
US

V. Phone/Fax

Practice location:
  • Phone: 818-399-7039
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number128530-01
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: