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General NPI Number Information
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NPI Number | 1346173895
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Entity Type | Organization
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Legal Business Name | SAMANTHA SIMON COUNSELING, PC
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Dates
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Enumeration Date | 06/04/2026
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Last Update Date | 06/04/2026
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Provider Practice Location Address
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Address Line | 109 VAN BUREN ST
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-1236
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Country | US
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Telephone | 269-779-1023
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Fax |
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Provider Business Mailing Address
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Address Line | 109 VAN BUREN ST
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City | SOUTH HAVEN
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State | MI
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Zip | 49090-1236
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Country | US
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Telephone | 269-779-1023
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Fax |
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Authorized Official
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Title or Position | LIMITED LICENSED PSYCHOLOGIST
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Name | SAMANTHA ANN SIMON
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Credential | MA LLP
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Telephone | 269-779-1023
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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