Provider Demographics
NPI:1831393719
Name:SIMEONE, RACHEL JUSTINE (MA)
Entity type:Individual
Prefix:MISS
First Name:RACHEL
Middle Name:JUSTINE
Last Name:SIMEONE
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 W 51ST ST
Mailing Address - Street 2:APARTMENT 1
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64112-2431
Mailing Address - Country:US
Mailing Address - Phone:816-531-7787
Mailing Address - Fax:
Practice Address - Street 1:8150 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-5806
Practice Address - Country:US
Practice Address - Phone:816-508-3517
Practice Address - Fax:816-508-3535
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2006031503101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional