Provider Demographics
NPI:1740932300
Name:SIMON, VARSHA ELIZABETH (LSW)
Entity type:Individual
Prefix:MS
First Name:VARSHA
Middle Name:ELIZABETH
Last Name:SIMON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 NEW ABBEY DR
Mailing Address - Street 2:
Mailing Address - City:INVERNESS
Mailing Address - State:IL
Mailing Address - Zip Code:60010-6180
Mailing Address - Country:US
Mailing Address - Phone:847-767-2521
Mailing Address - Fax:
Practice Address - Street 1:405 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:NORTHFIELD
Practice Address - State:IL
Practice Address - Zip Code:60093-3006
Practice Address - Country:US
Practice Address - Phone:847-441-5600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-24
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.106.423104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker