Provider Demographics
NPI:1245418029
Name:SIMONS, WESLEY M (LMFT)
Entity type:Individual
Prefix:
First Name:WESLEY
Middle Name:M
Last Name:SIMONS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 LOTHROP ST
Mailing Address - Street 2:
Mailing Address - City:BEVERLY
Mailing Address - State:MA
Mailing Address - Zip Code:01915-4624
Mailing Address - Country:US
Mailing Address - Phone:617-320-1749
Mailing Address - Fax:781-270-1945
Practice Address - Street 1:145 LOTHROP ST
Practice Address - Street 2:
Practice Address - City:BEVERLY
Practice Address - State:MA
Practice Address - Zip Code:01915-4624
Practice Address - Country:US
Practice Address - Phone:617-320-1749
Practice Address - Fax:781-270-1945
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1052106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist