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NPI Code Detail

MEDICARE: MRS. STEPHANIE RAE SIMON LCSW, NCPSYA

MEDICARE: MRS. STEPHANIE RAE SIMON LCSW, NCPSYA
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
11041C0700XClinical Social Worker44SC04307700NJ

General Provider Information

NPI Number : 1336210442
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. STEPHANIE RAE SIMON LCSW, NCPSYA
Provider Business Mailing Address
First Line : 10307 CRYSTAL RIDGE DR
Second Line :
City : WATCHUNG
State : NJ
Zip : 07069-6499
Country : US
Telephone Number : 908-403-6516
Fax Number : 908-248-0836
Provider Business Practice Location Address
First Line : 506 3RD ST
Second Line :
City : HOBOKEN
State : NJ
Zip : 07030-1970
Country : US
Telephone Number : 908-403-6516
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2006
Last Update Date : 06/12/2024

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