Active NPI
Suzanne Simon, M.A.
- Mental Health Counselor
- Portland, ME
National Provider Identifier
1417966102
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- CC2723
- Practice address
- 95 Exchange St
New England Family Institute, Suite 100
Portland, ME 04101 - Phone
- (207) 871-1000
- Fax
- (207) 773-0472
- NPI assigned
- Aug 5, 2006
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | CC2723 | ME | Primary |
Addresses
Primary practice location
95 Exchange St
New England Family Institute, Suite 100
Portland, ME 04101
Mailing address
67 Maietta Parkway
Unit 7
South Portland, ME 04106
Phone (207) 799-1749
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 048364 | Other | ME | PROVIDER #-ANTHEM |
| 355527 | Other | ME | PROVIDER #-MHN/TRICARE |
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 |
|---|---|---|---|
| CC2723 | ME | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| New England Family Institute | Mental Health | Past | Accepting new patients |
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Mental Health Counselor
- Portland, ME
- NPI 1942470349
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154736000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1417966102",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "67 MAIETTA PARKWAY",
"address_2": "UNIT 7",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "04106",
"telephone_number": "207-799-1749",
"fax_number": "207-773-0472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "95 EXCHANGE ST",
"address_2": "NEW ENGLAND FAMILY INSTITUTE, SUITE 100",
"city": "PORTLAND",
"state": "ME",
"postal_code": "04101",
"telephone_number": "207-871-1000",
"fax_number": "207-773-0472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "SUZANNE",
"credential": "M.A.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-08-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "ME",
"license": "CC2723",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER #-ANTHEM",
"identifier": "048364",
"state": "ME"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROVIDER #-MHN/TRICARE",
"identifier": "355527",
"state": "ME"
}
],
"endpoints": [],
"other_names": []
}Other providers in Portland, ME
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.