Provider Demographics
NPI:1407248818
Name:SIMEONE, DAVID GERALD (MA, LPC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:GERALD
Last Name:SIMEONE
Suffix:
Gender:M
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 KATHRYN DR
Mailing Address - Street 2:BLDG 3 STE. D
Mailing Address - City:LEWISVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75067-4216
Mailing Address - Country:US
Mailing Address - Phone:800-972-0643
Mailing Address - Fax:214-272-2162
Practice Address - Street 1:105 KATHRYN DR
Practice Address - Street 2:BLDG 3 STE. D
Practice Address - City:LEWISVILLE
Practice Address - State:TX
Practice Address - Zip Code:75067-4216
Practice Address - Country:US
Practice Address - Phone:800-972-0643
Practice Address - Fax:214-272-2162
Is Sole Proprietor?:No
Enumeration Date:2015-02-22
Last Update Date:2015-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX69873101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional