Provider Demographics
NPI:1568845550
Name:SIMON, RACHEL E (MSW, LCSW, MED)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:E
Last Name:SIMON
Suffix:
Gender:F
Credentials:MSW, LCSW, MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1518 WALNUT ST STE 401
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19102-3403
Mailing Address - Country:US
Mailing Address - Phone:240-620-4966
Mailing Address - Fax:
Practice Address - Street 1:1518 WALNUT ST STE 401
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19102
Practice Address - Country:US
Practice Address - Phone:240-620-4966
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-08
Last Update Date:2019-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW1324921041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical