Provider Demographics
NPI:1538248802
Name:ST. THOMAS-SIMONEAU, SHERRIE L (LCSW)
Entity type:Individual
Prefix:
First Name:SHERRIE
Middle Name:L
Last Name:ST. THOMAS-SIMONEAU
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1150
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:ME
Mailing Address - Zip Code:04211-1150
Mailing Address - Country:US
Mailing Address - Phone:207-333-3278
Mailing Address - Fax:207-333-3037
Practice Address - Street 1:700 SACO RD
Practice Address - Street 2:
Practice Address - City:STANDISH
Practice Address - State:ME
Practice Address - Zip Code:04084-6240
Practice Address - Country:US
Practice Address - Phone:207-648-7829
Practice Address - Fax:207-929-9147
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC106231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME2993OtherCERT. ALCOHOL AND D
ME431809199Medicaid
MERB9OtherANTHEM