Individual provider Active NPI

Scott Stephen Simon, LMFT

  • Marriage & Family Therapist
  • Stamford, CT
National Provider Identifier
1326702853
Registry record updated Oct 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
2750 Issued in CT
Practice address
184 Summer St Apt 2206
Stamford, CT 06901-2373
Phone
(203) 984-1824
NPI assigned
Oct 31, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 31, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 2750 CT Primary

Addresses

Primary practice location

184 Summer St Apt 2206
Stamford, CT 06901-2373

Mailing address

184 Summer St Apt 2206
Stamford, CT 06901-2373
Phone (203) 984-1824

Electronic endpoints 2

TypeEndpointUseAffiliation
Other URL redeemwellnesscenter.com Direct
Other URL scott@redeemwellnesscenter.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20240510000736 CT Practitioner - Marriage and Family Therapist 6608217484 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2750CTMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Redeem Wellness Center, LLC Marriage & Family Therapist CurrentSince Apr 1, 2024 Accepting new patients

Locations

4699 Main St
Ste 210
Bridgeport, CT 06606
Phone (203) 208-3940

Organizations & group practices 1

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": "1635638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635638400000",
    "number": "1326702853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "184 SUMMER ST APT 2206",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069012373",
            "telephone_number": "203-984-1824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "184 SUMMER ST APT 2206",
            "city": "STAMFORD",
            "state": "CT",
            "postal_code": "069012373",
            "telephone_number": "203-984-1824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "SCOTT",
        "middle_name": "STEPHEN",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-10-31",
        "last_updated": "2021-10-31",
        "certification_date": "2021-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CT",
            "license": "2750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "redeemwellnesscenter.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4699 Main St Ste 210",
            "city": "Bridgeport",
            "state": "CT",
            "country_code": "US",
            "postal_code": "066061830",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "scott@redeemwellnesscenter.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "useOtherDescription": "mobile phone",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "184 Summer St Apt 2206",
            "city": "Stamford",
            "state": "CT",
            "country_code": "US",
            "postal_code": "069012373",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Stamford, CT

Sources for this page

Verify at the official NPI Registry.