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KIMBERLEY SIMON LCSW
Clinical >> Social Worker >> Behavioral Health & Social Service ProvidersRegistrant NPI Number: 1396046777
Individual Registrant: KIMBERLEY SIMON LCSW
Gender: F
Not Sole Proprietor
Gender: F
Not Sole Proprietor
Location and contact information for practice:
404 C MILLER AVENUE TYBEE ISLAND, GA 31328 US
Tel: 330-550-3347 Fax: --
Tel: 330-550-3347 Fax: --
Contact information for business:
PO BOX 1782 TYBEE ISLAND, GA 31328-1782 US
Tel: -- Fax: --
Tel: -- Fax: --
Registration Information:
NPI: 1396046777
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| N | 1041C0700X | Behavioral Health & Social Service Providers Social Worker Clinical | OH | I1000299 |
| Y | 1041C0700X | Behavioral Health & Social Service Providers Social Worker | GA | CSW004497 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
