Provider Demographics
NPI:1326374513
Name:SIMON, MARIE LINDA (MS, NCC)
Entity type:Individual
Prefix:MISS
First Name:MARIE
Middle Name:LINDA
Last Name:SIMON
Suffix:
Gender:F
Credentials:MS, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5631 N WINSTON PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:COCONUT CREEK
Mailing Address - State:FL
Mailing Address - Zip Code:33073-5049
Mailing Address - Country:US
Mailing Address - Phone:954-655-3148
Mailing Address - Fax:
Practice Address - Street 1:5631 N WINSTON PARK BLVD
Practice Address - Street 2:
Practice Address - City:COCONUT CREEK
Practice Address - State:FL
Practice Address - Zip Code:33073-5049
Practice Address - Country:US
Practice Address - Phone:954-655-3148
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-23
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
325599OtherNATIONAL CERTIFIED COUNSELOR