Provider Demographics
NPI:1972546505
Name:SIMON, ROBIN MICHELLE (LMHC)
Entity type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MICHELLE
Last Name:SIMON
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 1:78 SALISBURY ST
Mailing Address - Street 2:
Mailing Address - City:REHOBOTH
Mailing Address - State:MA
Mailing Address - Zip Code:02769-1326
Mailing Address - Country:US
Mailing Address - Phone:508-930-2306
Mailing Address - Fax:
Practice Address - Street 1:155 MAIN RD
Practice Address - Street 2:
Practice Address - City:TIVERTON
Practice Address - State:RI
Practice Address - Zip Code:02878-1236
Practice Address - Country:US
Practice Address - Phone:401-624-7473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC00185101Y00000X
MA5180101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101Y00000XBehavioral Health & Social Service ProvidersCounselor
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health