Provider Demographics
NPI:1285378067
Name:SIMON, LOIS ANNETTE (MSW LCSW-BACS)
Entity type:Individual
Prefix:MS
First Name:LOIS
Middle Name:ANNETTE
Last Name:SIMON
Suffix:
Gender:F
Credentials:MSW LCSW-BACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5221 RICHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-4223
Mailing Address - Country:US
Mailing Address - Phone:504-583-1995
Mailing Address - Fax:
Practice Address - Street 1:5221 RICHLAND DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-4223
Practice Address - Country:US
Practice Address - Phone:504-583-1995
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA33501041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical