MEDICARE: GRANT SIMON PLMFT, PLPC

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	106H00000X	Marriage & Family Therapist	PLM1598	LA
2	171M00000X	Case Manager/Care Coordinator
3	101Y00000X	Counselor	PLC10801	LA

General Provider Information

NPI Number	:	1871480863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GRANT SIMON PLMFT, PLPC

Provider Business Mailing Address
First Line	:	1325 WRIGHT AVE STE B
Second Line	:
City	:	CROWLEY
State	:	LA
Zip	:	70526-2226
Country	:	US
Telephone Number	:	337-849-6418
Fax Number	:

Provider Business Practice Location Address
First Line	:	1325 WRIGHT AVE
Second Line	:
City	:	CROWLEY
State	:	LA
Zip	:	70526-2226
Country	:	US
Telephone Number	:	337-514-5181
Fax Number	:

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

Provider Enumeration Date	:	06/23/2025
Last Update Date	:	03/23/2026

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