Marni B Simon, MA, CCC-SLP, BCS-S

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA15801 Issued in FL

Practice address

565 Acacia Ave
Melbourne Village, FL 32904

Phone

(850) 857-9343

Fax

(844) 848-7557

NPI assigned

Jun 30, 2018

Last updated

Mar 17, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1530316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552780800000",
    "number": "1184119299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "565 ACACIA AVE",
            "city": "MELBOURNE VILLAGE",
            "state": "FL",
            "postal_code": "329042501",
            "telephone_number": "850-857-9343",
            "fax_number": "844-848-7557"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ACACIA AVE",
            "city": "MELBOURNE VILLAGE",
            "state": "FL",
            "postal_code": "32904",
            "telephone_number": "850-857-9343",
            "fax_number": "844-848-7557"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "565 Acacia Ave",
            "address_purpose": "LOCATION",
            "city": "Melbourne Village",
            "state": "FL",
            "postal_code": "32904",
            "country_code": "US",
            "telephone_number": "850-857-9343",
            "fax_number": "844-848-7557",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MARNI",
        "middle_name": "B",
        "credential": "MA, CCC-SLP, BCS-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-30",
        "last_updated": "2019-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA15801",
            "primary": true
        },
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": "FL",
            "license": "SA15801",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Speech-Language Pathologist in Melbourne Village, FL
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2019; 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.