Active NPI
Mary L. Simbarcelos, MS, LPC
- Mental Health Counselor
- Pinedale, WY
National Provider Identifier
1497053144
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 1381
- Practice address
- 431 W. Pine St.
Pinedale, WY 82941 - Phone
- (402) 525-7509
- Fax
- (307) 367-2864
- NPI assigned
- Mar 4, 2011
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 405 | NE | |
| Psychoanalyst | 102L00000X | 1799 | NE | |
| Mental Health Counselor | 101YM0800X | 1381 | WY | Primary |
Addresses
Primary practice location
431 W. Pine St.
Pinedale, WY 82941
Mailing address
PO Box 1641
Pinedale, WY 82941-1641
Phone (402) 525-7509
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 710765000 | Other | NE | MAGELLAN |
| 10025915300 | Medicaid | NE |
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 Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1381 | WY | MD | Mental Health Counselor |
| 1799 | NE | MD | Chiropractor |
| 405 | NE | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1299196800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516924800000",
"number": "1497053144",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1641",
"city": "PINEDALE",
"state": "WY",
"postal_code": "829411641",
"telephone_number": "402-525-7509",
"fax_number": "307-367-2864"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "431 W. PINE ST.",
"city": "PINEDALE",
"state": "WY",
"postal_code": "82941",
"telephone_number": "402-525-7509",
"fax_number": "307-367-2864"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMBARCELOS",
"first_name": "MARY",
"middle_name": "L.",
"credential": "MS, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-03-04",
"last_updated": "2018-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NE",
"license": "405",
"primary": false
},
{
"code": "102L00000X",
"taxonomy_group": "",
"desc": "Psychoanalyst",
"state": "NE",
"license": "1799",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WY",
"license": "1381",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MAGELLAN",
"identifier": "710765000",
"state": "NE"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "10025915300",
"state": "NE"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pinedale, WY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 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.