Provider Demographics
NPI:1760541981
Name:SCIMONE, MARILYN ALTIERI (LMHC,RN,LRC)
Entity Type:Individual
Prefix:MRS
First Name:MARILYN
Middle Name:ALTIERI
Last Name:SCIMONE
Suffix:
Gender:F
Credentials:LMHC,RN,LRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 JOYCE RD
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MA
Mailing Address - Zip Code:01778-4516
Mailing Address - Country:US
Mailing Address - Phone:508-655-4122
Mailing Address - Fax:508-651-2773
Practice Address - Street 1:20 JOYCE RD
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MA
Practice Address - Zip Code:01778-4516
Practice Address - Country:US
Practice Address - Phone:508-655-4122
Practice Address - Fax:508-651-2773
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA888101YM0800X
MA77674163WC1500X
MA433225400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
Not Answered225400000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRehabilitation Practitioner