Active NPI
Matthew Simon, MA, LMFT
- Marriage & Family Therapist
- Charlotte, NC
National Provider Identifier
1386955375
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- 1414
- Practice address
- 769 N Wendover Rd
Charlotte, NC 28211-1118 - Phone
- (704) 376-7180
- Fax
- (704) 536-0375
- NPI assigned
- Jun 24, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | 1414 | NC | Primary |
Addresses
Primary practice location
769 N Wendover Rd
Charlotte, NC 28211-1118
Mailing address
4885 Prowess Lane
Indian Land, SC 29707
Other practice location 1
1265 Tanner Crossing Ln
Indian Land, SC 29707-1522
Phone (704) 771-9582
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1414 | NC | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1386955375",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4885 PROWESS LANE",
"city": "INDIAN LAND",
"state": "SC",
"postal_code": "29707"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "769 N WENDOVER RD",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282111118",
"telephone_number": "704-376-7180",
"fax_number": "704-536-0375"
}
],
"practiceLocations": [
{
"address_1": "1265 Tanner Crossing Ln",
"address_purpose": "LOCATION",
"city": "Indian Land",
"state": "SC",
"postal_code": "297071522",
"country_code": "US",
"telephone_number": "704-771-9582",
"fax_number": "704-536-0375",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "SIMON",
"first_name": "MATTHEW",
"credential": "MA, LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-24",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "NC",
"license": "1414",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.