Provider Demographics
NPI:1780391250
Name:SIMONSON, STEPHANIE ANNA (MSW, LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:ANNA
Last Name:SIMONSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 W GROVE ST
Mailing Address - Street 2:
Mailing Address - City:ALMA CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:54611-9770
Mailing Address - Country:US
Mailing Address - Phone:608-807-9183
Mailing Address - Fax:
Practice Address - Street 1:517 COURT ST
Practice Address - Street 2:
Practice Address - City:NEILLSVILLE
Practice Address - State:WI
Practice Address - Zip Code:54456-1971
Practice Address - Country:US
Practice Address - Phone:715-743-5233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-03
Last Update Date:2023-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1109-122104100000X
WI11318-1231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker