Provider Demographics
NPI:1669494712
Name:SIMON, JOEL (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:
Last Name:SIMON
Suffix:
Gender:M
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 N BROWNING AVE
Mailing Address - Street 2:
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-1912
Mailing Address - Country:US
Mailing Address - Phone:201-871-6867
Mailing Address - Fax:201-871-6709
Practice Address - Street 1:55 N BROWNING AVE
Practice Address - Street 2:
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-1912
Practice Address - Country:US
Practice Address - Phone:201-871-6867
Practice Address - Fax:201-871-6709
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC00133700101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health