Provider Demographics
NPI:1992843486
Name:SIMON, ANNETTE ZAFFOS (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ANNETTE
Middle Name:ZAFFOS
Last Name:SIMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 MORTON BLVD
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-5616
Mailing Address - Country:US
Mailing Address - Phone:516-939-0689
Mailing Address - Fax:
Practice Address - Street 1:520 FRANKLIN AVENUE
Practice Address - Street 2:SUITE 211
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-840-1033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR02382311041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
6244518OtherUNITED BEHAVIORAL HEALTH
NY7343801OtherVALUE OPTIONS EMPIRE
NYN769D1Medicare ID - Type Unspecified