Provider Demographics
NPI:1467174037
Name:SIMONE, REBECCA (LPCC)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:SIMONE
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:RIVER
Other - Middle Name:
Other - Last Name:SIMONE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2637 VALMONT RD UNIT 3B
Mailing Address - Street 2:
Mailing Address - City:BOULDER
Mailing Address - State:CO
Mailing Address - Zip Code:80304-2950
Mailing Address - Country:US
Mailing Address - Phone:720-340-3511
Mailing Address - Fax:
Practice Address - Street 1:2637 VALMONT RD UNIT 3B
Practice Address - Street 2:
Practice Address - City:BOULDER
Practice Address - State:CO
Practice Address - Zip Code:80304-2950
Practice Address - Country:US
Practice Address - Phone:720-340-3511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-12
Last Update Date:2022-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPCC.0019555101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health