Provider Demographics
NPI:1306293527
Name:TOTORO, SIMONE (LPC, LCADC)
Entity type:Individual
Prefix:
First Name:SIMONE
Middle Name:
Last Name:TOTORO
Suffix:
Gender:F
Credentials:LPC, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:189 SOUTHAMPTON DR
Mailing Address - Street 2:
Mailing Address - City:GALLOWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08205-6626
Mailing Address - Country:US
Mailing Address - Phone:609-515-4155
Mailing Address - Fax:
Practice Address - Street 1:6680 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-1825
Practice Address - Country:US
Practice Address - Phone:609-515-4155
Practice Address - Fax:609-380-7924
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-17
Last Update Date:2020-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00241400101YA0400X
FLMH9148101YM0800X
NJ37PC00544400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health