Provider Demographics
NPI:1225419997
Name:SIMONS, CLOTILDE (LCSW, M-CASAC, CAMS1)
Entity Type:Individual
Prefix:MS
First Name:CLOTILDE
Middle Name:
Last Name:SIMONS
Suffix:
Gender:F
Credentials:LCSW, M-CASAC, CAMS1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 FLATBUSH AVE STE 243
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3262
Mailing Address - Country:US
Mailing Address - Phone:646-272-8912
Mailing Address - Fax:347-689-4677
Practice Address - Street 1:1623 FLATBUSH AVE STE 243
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3262
Practice Address - Country:US
Practice Address - Phone:646-272-8912
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-17
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY18689101YA0400X
NY088896-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)