Provider Demographics
NPI:1740983097
Name:NOMO, SIMEON
Entity type:Individual
Prefix:DR
First Name:SIMEON
Middle Name:
Last Name:NOMO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 CONNECTICUT AVE NW APT 504
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-2204
Mailing Address - Country:US
Mailing Address - Phone:240-506-6401
Mailing Address - Fax:
Practice Address - Street 1:4801 CONNECTICUT AVE NW APT 504
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-2204
Practice Address - Country:US
Practice Address - Phone:240-506-6401
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-24
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No251S00000XAgenciesCommunity/Behavioral Health