Individual provider Active NPI

Tola Simeon, LMSW

  • Social Worker
  • Staten Island, NY
National Provider Identifier
1467731810
Registry record updated Aug 16, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
071435-1 Issued in NY
Practice address
194 Targee St
Staten Island, NY 10304-1926
Phone
(718) 390-0561
Fax
(718) 390-5166
NPI assigned
Aug 16, 2011
Last updated
Aug 16, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 071435-1 NY Primary

Addresses

Primary practice location

194 Targee St
Staten Island, NY 10304-1926

Mailing address

84B Andros Ave
Staten Island, NY 10303-2047
Phone (347) 857-0775

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

State licenses

LicenseStateTypeSpecialty
071435-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Fadmo Health and Home Care Agency Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1313452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313452800000",
    "number": "1467731810",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "84B ANDROS AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103032047",
            "telephone_number": "347-857-0775"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 TARGEE ST",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041926",
            "telephone_number": "718-390-0561",
            "fax_number": "718-390-5166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMEON",
        "first_name": "TOLA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-16",
        "last_updated": "2011-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "071435-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2011; 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.