Provider Demographics
NPI:1972806461
Name:SIMON, VANIA MERCEDES (MS, LMHC-QS)
Entity type:Individual
Prefix:MRS
First Name:VANIA
Middle Name:MERCEDES
Last Name:SIMON
Suffix:
Gender:F
Credentials:MS, LMHC-QS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10671 N KENDALL DR
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33176-1510
Mailing Address - Country:US
Mailing Address - Phone:786-416-0811
Mailing Address - Fax:786-558-5483
Practice Address - Street 1:10671 N KENDALL DR
Practice Address - Street 2:
Practice Address - City:MIAMI
Practice Address - State:FL
Practice Address - Zip Code:33176-1510
Practice Address - Country:US
Practice Address - Phone:786-416-0811
Practice Address - Fax:786-558-5483
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-06
Last Update Date:2024-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10238103K00000X, 253J00000X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No253J00000XAgenciesFoster Care Agency
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMH10838OtherFLORIDA DEPARTMENT OF HEALTH