Individual provider Active NPI

Kathryn A Simon

  • Clinical Child & Adolescent Psychologist
  • New Orleans, LA
National Provider Identifier
1023671799
Registry record updated Aug 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
License
1723 Issued in LA
Practice address
1430 Tulane Ave # 8422
New Orleans, LA 70112-2632
Phone
(504) 422-3545
NPI assigned
Apr 18, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X
Clinical Child & Adolescent Psychologist 103TC2200X 1723 LA Primary

Addresses

Primary practice location

1430 Tulane Ave # 8422
New Orleans, LA 70112-2632

Mailing address

1430 Tulane Ave # 8422
New Orleans, LA 70112-2632
Phone (504) 422-3545

Other practice location 1

1011 Veterans Memorial Pkwy
Riverside, RI 02915-5061
Phone (401) 432-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, LA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20201007002287 RI Practitioner - Clinical Psychologist 0941629182 Reassigns benefits to 2 organizations
I20250430002247 LA Practitioner - Clinical Psychologist 0941629182 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
1723LAMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Administrators of the Tulane Educational Fund Current Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Feb 3, 2025 Accepting new patients
Lifespan Physician Group, Inc. Psychologist CurrentSince Aug 14, 2020 Accepting new patients
Lifespan Physician Group, Inc. CurrentSince Aug 14, 2020 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Aug 4, 2020 Accepting new patients
Administrators of the Tulane Education Fund CurrentSince Feb 3, 2025 Accepting new patients
Emma Pendleton Bradley Hospital CurrentSince Aug 4, 2020 Accepting new patients

Locations

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
#T
New Orleans, LA 70112

1430 Tulane Ave
#8422
New Orleans, LA 70112
Phone (504) 422-3545

4000 Bienville St
Ste G
New Orleans, LA 70119
Phone (504) 988-0301

1440 Canal St
Ste 1008
New Orleans, LA 70112

1440 Canal St
New Orleans, LA 70112
Phone (504) 988-4272

117 Ellenfield St
Ste 101
Providence, RI 02905
Phone (401) 444-4318

593 Eddy St
Providence, RI 02903

1011 Veterans Memorial Pkwy
Riverside, RI 02915
Phone (401) 432-1000

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/GCFJBA/Endpoint/GCFJBA

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1555545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756166400000",
    "number": "1023671799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # 8422",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-422-3545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1430 TULANE AVE # 8422",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701122632",
            "telephone_number": "504-422-3545"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1011 Veterans Memorial Pkwy",
            "address_purpose": "LOCATION",
            "city": "Riverside",
            "state": "RI",
            "postal_code": "029155061",
            "country_code": "US",
            "telephone_number": "401-432-1000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "KATHRYN",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-18",
        "last_updated": "2025-08-26",
        "certification_date": "2025-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "LA",
            "license": "1723",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.