Jacqueline Lisa Simon, PSY.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

015689 Issued in NY

Practice address

329 E 62ND St
New York, NY 10021-7705

Phone

(212) 838-4333

Fax

(212) 838-7158

NPI assigned

Jan 17, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Upper East Side Psychology Services P.C.

  • Clinical Psychologist
  • New York, NY
  • NPI 1760784243
  NPD (past) Authorized official

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1285786483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 E 70TH ST",
            "address_2": "APT. 1FE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100218625",
            "telephone_number": "646-242-0686",
            "fax_number": "212-838-7158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "329 E 62ND ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100217705",
            "telephone_number": "212-838-4333",
            "fax_number": "212-838-7158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JACQUELINE",
        "middle_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-17",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "015689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emma Simon, CNM
• Emma Simon
• Erika Chante Simon, NP
• Gregory W Simon, MD
• Hannah Simon, MD
• Jane Simon, MD
• Jean Pascal Simon, MD
• Jena Marie Simon, DNP
• Jessica Simon, MD
• Jonathan M Simon

• Clinical Psychologist in New York, NY
• Providers in New York, NY by specialty
• Clinical Psychologist in New York

• 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.