Provider Demographics
NPI:1720420938
Name:BRITTANY SIMON LCPC LLC
Entity Type:Organization
Organization Name:BRITTANY SIMON LCPC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRITTANY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMON
Authorized Official - Suffix:
Authorized Official - Credentials:LCPC
Authorized Official - Phone:317-331-7637
Mailing Address - Street 1:800 E NORTHWEST HWY STE 500
Mailing Address - Street 2:
Mailing Address - City:PALATINE
Mailing Address - State:IL
Mailing Address - Zip Code:60074-6511
Mailing Address - Country:US
Mailing Address - Phone:317-331-7637
Mailing Address - Fax:
Practice Address - Street 1:800 E NORTHWEST HWY STE 500
Practice Address - Street 2:
Practice Address - City:PALATINE
Practice Address - State:IL
Practice Address - Zip Code:60074-6511
Practice Address - Country:US
Practice Address - Phone:317-331-7637
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-07-29
Last Update Date:2013-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180008707101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty