Individual provider Active NPI

Stephen E. Simon, LCSW C

  • Clinical Social Worker
  • Frederick, MD
National Provider Identifier
1174722102
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
12763 Issued in MD
Practice address
13 E 2ND St
Frederick, MD 21701-5302
Phone
(301) 694-8684
Fax
(301) 694-2984
NPI assigned
Jul 11, 2007
Last updated
Oct 22, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 12763 MD Primary

Addresses

Primary practice location

13 E 2ND St
Frederick, MD 21701-5302

Mailing address

13 E 2ND St
Frederick, MD 21701-5302
Phone (301) 694-8684

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, MD2 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
I20180130001787 DC Practitioner - Clinical Social Worker 5496015000 Reassigns benefits to 1 organization
I20180829000974 MD Practitioner - Clinical Social Worker 5496015000 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1003 W 7TH St
Suite 200
Frederick, MD 21701-4106
Phone (301) 245-6300

7474 Greenway Ctr Dr
Suite 700a
Greenbelt, MD 20770-3523
Phone (301) 982-3437

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12763MDMDClinical Social Worker
12743MDMDOrthodontics and Dentofacial Orthopedic Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Lifespan Behavioral Health Services PC CurrentSince Apr 15, 2020 Accepting new patients
Lifespan Behavioral Health Services PC CurrentSince Apr 15, 2020 Accepting new patients
Lifespan Behavioral Health Services PC CurrentSince Jul 12, 2022 Accepting new patients
Harper and Associates Clinical Past Accepting new patients

Locations

1003 W 7th St
Ste 200
Frederick, MD 21701
Phone (240) 651-6824

7474 Greenway Center Dr
Ste 700A
Greenbelt, MD 20770
Phone (301) 982-3437

3416 Olandwood Ct
Ste 201
Olney, MD 20832
Phone (301) 774-9400

3460 Olney Laytonsville Rd
Ste 212
Olney, MD 20832
Phone (301) 982-3437

101 E Chesapeake Ave
Ste 401
Towson, MD 21286
Phone (301) 982-3437

Organizations & group practices 4

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

NPI Registry JSON

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

{
    "created_epoch": "1184112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1174722102",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13 E 2ND ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015302",
            "telephone_number": "301-694-8684",
            "fax_number": "301-694-2984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13 E 2ND ST",
            "city": "FREDERICK",
            "state": "MD",
            "postal_code": "217015302",
            "telephone_number": "301-694-8684",
            "fax_number": "301-694-2984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "STEPHEN",
        "middle_name": "E.",
        "credential": "LCSW C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-11",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "12763",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frederick, MD

Sources for this page

Verify at the official NPI Registry.