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NPI Code Detail

MEDICARE: MS. CLOTILDE SIMONS LCSW, M-CASAC, CAMS1

MEDICARE: MS. CLOTILDE SIMONS LCSW, M-CASAC, CAMS1
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor18689NY
21041C0700XClinical Social Worker088896-01NY

General Provider Information

NPI Number : 1225419997
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CLOTILDE SIMONS LCSW, M-CASAC, CAMS1
Provider Business Mailing Address
First Line : 1623 FLATBUSH AVE STE 243
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 646-272-8912
Fax Number : 347-689-4677
Provider Business Practice Location Address
First Line : 1623 FLATBUSH AVE STE 243
Second Line :
City : BROOKLYN
State : NY
Zip : 11210-3262
Country : US
Telephone Number : 646-272-8912
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2015
Last Update Date : 03/07/2022

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