MEDICARE: SIMONE LES

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
1	1041C0700X	Clinical Social Worker	128530-01	NY

General Provider Information

NPI Number	:	1699638478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIMONE LES

Provider Business Mailing Address
First Line	:	93 WYCKOFF AVE APT 1A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-2988
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	93 WYCKOFF AVE APT 1A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-2988
Country	:	US
Telephone Number	:	818-399-7039
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/08/2025
Last Update Date	:	12/08/2025

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Directions to “ SIMONE LES ” Practice Location

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