Provider Demographics
NPI:1962157305
Name:SIMONEAU, PATRYCJA A (LMHC)
Entity type:Individual
Prefix:
First Name:PATRYCJA
Middle Name:A
Last Name:SIMONEAU
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 DAISY LN
Mailing Address - Street 2:
Mailing Address - City:CHELMSFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01824-1278
Mailing Address - Country:US
Mailing Address - Phone:781-510-9615
Mailing Address - Fax:
Practice Address - Street 1:11 DAISY LN
Practice Address - Street 2:
Practice Address - City:CHELMSFORD
Practice Address - State:MA
Practice Address - Zip Code:01824-1278
Practice Address - Country:US
Practice Address - Phone:781-510-9615
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-15
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5849101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty