Heidi Jolene Simon, LICSW

Individual provider Active NPI Clinical Social Worker · Montgomery, MN

NPI 1457069643 · NPPES record last updated Nov 14, 2022

Key facts

NPI
1457069643
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
14197 (MN)
Practice address
9733 Kent Ave
Montgomery, MN 56069-4903
Phone
(612) 227-9310
NPI assigned
Nov 7, 2022
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 14197 MN Yes

Addresses

Primary practice location

9733 Kent Ave
Montgomery, MN 56069-4903

Mailing address

9733 Kent Ave
Montgomery, MN 56069-4903
Phone (612) 227-9310

Other providers in Montgomery, MN

All providers in Montgomery, MN · Clinical Social Worker in Minnesota

Sources for this page

Verify at the official NPI Registry.