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General NPI Number Information
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NPI Number | 1902034358
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Entity Type | Individual
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Provider Name | ELIA SIMON LPC
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Gender | Female
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Dates
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Enumeration Date | 06/24/2009
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Last Update Date | 02/02/2023
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Provider Practice Location Address
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Address Line | 1151 S. FOREST AVENUE SUITE 334
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City | TEMPE
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State | AZ
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Zip | 85287
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Country | US
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Telephone | 480-965-6146
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3242
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City | TEMPE
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State | AZ
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Zip | 85280-3242
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Country | US
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Telephone |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | LPC-14199
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License Number State | AZ
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