Provider Demographics
NPI:1245323500
Name:SIMON, LINDA DEANN (LPC)
Entity type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:DEANN
Last Name:SIMON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 MOUNTAIN CHASE RD SW
Mailing Address - Street 2:
Mailing Address - City:ROME
Mailing Address - State:GA
Mailing Address - Zip Code:30165-8577
Mailing Address - Country:US
Mailing Address - Phone:706-766-8318
Mailing Address - Fax:706-235-9402
Practice Address - Street 1:412 E 1ST ST
Practice Address - Street 2:
Practice Address - City:ROME
Practice Address - State:GA
Practice Address - Zip Code:30161-3104
Practice Address - Country:US
Practice Address - Phone:706-235-6990
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA004564101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional