Simple Serenity Therapy Center

Primary specialty

Group Psychotherapy PsychologistTaxonomy code 103TP2701X

Legal business name

SIMPLE SERENITY THERAPY CENTER

Practice address

125 Tejah Ave
Syracuse, NY 13210

Phone

(315) 313-4733

NPI assigned

Jul 19, 2021

Organization subpart

No

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

Authorized official

Name

Nicole Defurio, LCSW-RNPI 1043532476

Title

Owner/Therapist

Phone

(315) 806-3008

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Defurio, LCSW

  • Counselor
  • Syracuse, NY
  • NPI 1043532476
  NPD Authorized official

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

{
    "created_epoch": "1626652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626652800000",
    "number": "1528631504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 TEJAH AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-806-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 TEJAH AVE",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "13210",
            "telephone_number": "315-313-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SIMPLE SERENITY THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-19",
        "last_updated": "2021-07-19",
        "certification_date": "2021-07-19",
        "status": "A",
        "authorized_official_last_name": "DEFURIO",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/THERAPIST",
        "authorized_official_telephone_number": "315-806-3008",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "103TP2701X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Group Psychotherapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04125137",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Heather Simmons, CASAC-A
• Jacquelyn Malloy Simmons, LCSW BCD
• K Bruce Simmons, MD
• David G Simon, MD
• Simple Serenity Counseling LCSW, PLLC
• Simply Precious Hands LLC (Simply Precious Hands)
• Simpson Family Wellness: Chiropractic, PLLC
• Anna-Marie Simpson, D.C., MSACN
• Maria A Sims, LPN
• Tariq Sims

• Group Psychotherapy Psychologist in Syracuse, NY
• Providers in Syracuse, NY by specialty
• Group Psychotherapy Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2021; 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.