Healthcare Provider Details

I. General information

NPI: 1871004143
Provider Name (Legal Business Name): NAYFITD SIMONS LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2017
Last Update Date: 11/02/2022
Certification Date: 11/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MAIN ST
PEEKSKILL NY
10566-2907
US

IV. Provider business mailing address

1101 MAIN ST
PEEKSKILL NY
10566-2907
US

V. Phone/Fax

Practice location:
  • Phone: 914-737-7338
  • Fax: 914-737-1050
Mailing address:
  • Phone: 914-737-7338
  • Fax: 914-737-1050

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number094356
License Number StateNY

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: