Provider Demographics
NPI:1427411321
Name:SIM, MARIA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:SIM
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 1:275 MAGNOLIA AVE STE 2195
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-2910
Mailing Address - Country:US
Mailing Address - Phone:562-247-2575
Mailing Address - Fax:
Practice Address - Street 1:275 MAGNOLIA AVE STE 2195
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90802-2910
Practice Address - Country:US
Practice Address - Phone:562-247-2575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-30
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCSW 223881041C0700X
CALCSW22388171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical