Provider Demographics
NPI:1740818921
Name:SIMIONE, PETER (PHD, LSSP)
Entity type:Individual
Prefix:DR
First Name:PETER
Middle Name:
Last Name:SIMIONE
Suffix:
Gender:M
Credentials:PHD, LSSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7887 SAN FELIPE ST STE 248
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77063-1621
Mailing Address - Country:US
Mailing Address - Phone:713-300-6326
Mailing Address - Fax:713-300-6326
Practice Address - Street 1:7887 SAN FELIPE ST STE 248
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77063-1621
Practice Address - Country:US
Practice Address - Phone:713-300-6326
Practice Address - Fax:713-300-6326
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-01
Last Update Date:2020-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX3-1260103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist