Provider Demographics
NPI:1407652324
Name:SIMON, CARMEN (MSW, APSW)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:SIMON
Suffix:
Gender:
Credentials:MSW, APSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:728 N JAMES LOVELL ST
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53233-2408
Mailing Address - Country:US
Mailing Address - Phone:414-449-4777
Mailing Address - Fax:
Practice Address - Street 1:728 N JAMES LOVELL ST
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53233-2408
Practice Address - Country:US
Practice Address - Phone:414-449-4777
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1299541041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical