Bruce Roland Simons, PHD

Primary specialty

Addiction (Substance Use Disorder) PsychologistTaxonomy code 103TA0400X

License

PS-015091 Issued in PA

Practice address

102 Center St
Ridgway, PA 15853-1716

Phone

(814) 772-5546

Fax

(814) 772-0511

NPI assigned

Mar 14, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Nelson Behavioral Center

  • Psychologist
  • Ridgway, PA
  • NPI 1518927920
  NPD (past) Authorized official
• Nelson Behavioral Center, Inc.

  • Community/Behavioral Health Agency
  • Ridgway, PA
  • NPI 1760496913

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1083748172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 CENTER ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531716",
            "telephone_number": "814-772-5546",
            "fax_number": "814-772-0511"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 CENTER ST",
            "city": "RIDGWAY",
            "state": "PA",
            "postal_code": "158531716",
            "telephone_number": "814-772-5546",
            "fax_number": "814-772-0511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMONS",
        "first_name": "BRUCE",
        "middle_name": "ROLAND",
        "name_prefix": "Mr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "PA",
            "license": "PS-015091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ridgway Area School District
• Rite Aid of Pennsylvania LLC
• Shauna Marie Scutella, PHMNP
• Alissa Rose Shelander
• Joseph Edward Sherry, LCSW
• Sydney Jeanne Spang, PA-C
• Mark Charles Spiers, DMD
• Amanda Straub
• Kylee Renee Streich, RN
• Narayana Subramany, M.D.

• Addiction (Substance Use Disorder) Psychologist in Ridgway, PA
• Providers in Ridgway, PA by specialty
• Addiction (Substance Use Disorder) Psychologist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.