Provider Demographics
NPI:1023549888
Name:SIMONS, KATHRYN E (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:SIMONS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32 DICKINSON AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13901-1714
Mailing Address - Country:US
Mailing Address - Phone:607-206-5751
Mailing Address - Fax:
Practice Address - Street 1:32 DICKINSON AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13901-1714
Practice Address - Country:US
Practice Address - Phone:607-206-5751
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-23
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0874731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical