Provider Demographics
NPI:1386286458
Name:SIMMEN, JONATHAN CHARLES (LCSW, LSW, MSW)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:CHARLES
Last Name:SIMMEN
Suffix:
Gender:M
Credentials:LCSW, LSW, MSW
Other - Prefix:
Other - First Name:JONATHAN
Other - Middle Name:CHARLES
Other - Last Name:SIMMEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:310 CENTRAL CITY PLZ
Mailing Address - Street 2:
Mailing Address - City:NEW KENSINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:15068-6441
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 CENTRAL CITY PLZ
Practice Address - Street 2:
Practice Address - City:NEW KENSINGTON
Practice Address - State:PA
Practice Address - Zip Code:15068-6441
Practice Address - Country:US
Practice Address - Phone:724-335-9883
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-10
Last Update Date:2019-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW0208471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical