Healthcare Provider Details

I. General information

NPI: 1972546505
Provider Name (Legal Business Name): ROBIN MICHELLE SIMON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/13/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

155 MAIN RD
TIVERTON RI
02878-1236
US

IV. Provider business mailing address

78 SALISBURY ST
REHOBOTH MA
02769-1326
US

V. Phone/Fax

Practice location:
  • Phone: 401-624-7473
  • Fax:
Mailing address:
  • Phone: 508-930-2306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHC00185
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number5180
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: