Provider Demographics
NPI:1790587582
Name:SIMONIAN, DOUGLAS ARAM (LMHC)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:ARAM
Last Name:SIMONIAN
Suffix:
Gender:
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:53 SHERMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE CENTRE
Mailing Address - State:NY
Mailing Address - Zip Code:11570-3135
Mailing Address - Country:US
Mailing Address - Phone:516-410-5301
Mailing Address - Fax:
Practice Address - Street 1:1757 MERRICK AVE STE 106
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-2717
Practice Address - Country:US
Practice Address - Phone:516-247-6449
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015822101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health