Provider Demographics
NPI:1134448590
Name:SIMCOX, NOAH JULIAN (LICSW)
Entity type:Individual
Prefix:MR
First Name:NOAH
Middle Name:JULIAN
Last Name:SIMCOX
Suffix:
Gender:M
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3843 GLENHURST AVE
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-4915
Mailing Address - Country:US
Mailing Address - Phone:651-646-2326
Mailing Address - Fax:
Practice Address - Street 1:4021 VERNON AVE S STE 306
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55416-2816
Practice Address - Country:US
Practice Address - Phone:651-646-2326
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-25
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN138051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical