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General NPI Number Information
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NPI Number | 1356159594
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Entity Type | Individual
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Provider Name | LAUREN ELIZABETH SIMON RCSWI
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Gender | Female
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Dates
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Enumeration Date | 12/19/2024
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 9400 4TH ST N STE 200
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City | SAINT PETERSBURG
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State | FL
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Zip | 33702-2501
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Country | US
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Telephone | 727-513-2962
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Fax |
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Provider Business Mailing Address
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Address Line | 3951 34TH ST S APT 4237
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City | ST PETERSBURG
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State | FL
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Zip | 33711-5911
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Country | US
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Telephone | 651-319-2791
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 20206
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License Number State | FL
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