Provider Demographics
NPI:1265130256
Name:SPRINGFIELD, SIMONE D (CADC)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:D
Last Name:SPRINGFIELD
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9733 SAINT CHARLES ROCK RD
Mailing Address - Street 2:
Mailing Address - City:BRECKENRIDGE HILLS
Mailing Address - State:MO
Mailing Address - Zip Code:63114-2625
Mailing Address - Country:US
Mailing Address - Phone:314-423-7030
Mailing Address - Fax:
Practice Address - Street 1:9733 SAINT CHARLES ROCK RD
Practice Address - Street 2:
Practice Address - City:BRECKENRIDGE HILLS
Practice Address - State:MO
Practice Address - Zip Code:63114-2625
Practice Address - Country:US
Practice Address - Phone:314-423-7030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-20
Last Update Date:2023-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO13977101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health