Provider Demographics
NPI:1477767572
Name:SIMON, JOEL K (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOEL
Middle Name:K
Last Name:SIMON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 IVY LN
Mailing Address - Street 2:
Mailing Address - City:WALDEN
Mailing Address - State:NY
Mailing Address - Zip Code:12586-2809
Mailing Address - Country:US
Mailing Address - Phone:845-778-7107
Mailing Address - Fax:
Practice Address - Street 1:7 IVY LN
Practice Address - Street 2:
Practice Address - City:WALDEN
Practice Address - State:NY
Practice Address - Zip Code:12586-2809
Practice Address - Country:US
Practice Address - Phone:845-778-7107
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY021732-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical