Provider Demographics
NPI:1679895072
Name:STEVEN G SIMON LCSW LLC
Entity Type:Organization
Organization Name:STEVEN G SIMON LCSW LLC
Other - Org Name:STEVEN G. SIMON, LCSW
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:GARY
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:203-287-2488
Mailing Address - Street 1:2348 WHITNEY AVE
Mailing Address - Street 2:SUITE 2
Mailing Address - City:HAMDEN
Mailing Address - State:CT
Mailing Address - Zip Code:06518-3512
Mailing Address - Country:US
Mailing Address - Phone:203-287-2488
Mailing Address - Fax:203-287-9133
Practice Address - Street 1:2348 WHITNEY AVE
Practice Address - Street 2:SUITE 2
Practice Address - City:HAMDEN
Practice Address - State:CT
Practice Address - Zip Code:06518-3512
Practice Address - Country:US
Practice Address - Phone:203-287-2488
Practice Address - Fax:203-287-9133
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-25
Last Update Date:2010-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0058971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty