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NPI Code Detail

MEDICARE: MARY MARSHALL SIMONSON LPC

MEDICARE: MARY MARSHALL SIMONSON LPC
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
1101YM0800XMental Health CounselorA8492NC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609142702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY MARSHALL SIMONSON LPC
Provider Business Mailing Address
First Line : 408 HERITAGE VILLAGE LN
Second Line :
City : APEX
State : NC
Zip : 27502-8492
Country : US
Telephone Number : 910-619-4650
Fax Number :
Provider Business Practice Location Address
First Line : 3125 POPLARWOOD CT
Second Line : SUITE 203
City : RALEIGH
State : NC
Zip : 27604-1084
Country : US
Telephone Number : 919-571-2932
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2012
Last Update Date : 01/07/2026

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