Provider Demographics
NPI:1568203149
Name:SIMON, ANNA KATHERINE (NCC)
Entity type:Individual
Prefix:MS
First Name:ANNA
Middle Name:KATHERINE
Last Name:SIMON
Suffix:
Gender:F
Credentials:NCC
Other - Prefix:MS
Other - First Name:KATEY
Other - Middle Name:
Other - Last Name:SIMON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7000 STONEWOOD DR STE 300
Mailing Address - Street 2:
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-8326
Mailing Address - Country:US
Mailing Address - Phone:724-242-8671
Mailing Address - Fax:
Practice Address - Street 1:7000 STONEWOOD DR STE 300
Practice Address - Street 2:
Practice Address - City:WEXFORD
Practice Address - State:PA
Practice Address - Zip Code:15090-8326
Practice Address - Country:US
Practice Address - Phone:724-242-8671
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-05
Last Update Date:2024-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health