Active NPI
Susan Marie Simitis, M.A.
- Mental Health Counselor
- Worcester, MA
National Provider Identifier
1629373873
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 2043
- Practice address
- 41 Oak Ave
Worcester, MA 01605-2730 - Phone
- (508) 832-9237
- NPI assigned
- Jan 19, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 2043 | MA | Primary |
| Clinical Social Worker | 1041C0700X | 202785 | MA |
Addresses
Primary practice location
41 Oak Ave
Worcester, MA 01605-2730
Mailing address
41 Oak Ave
Worcester, MA 01605-2730
Phone (508) 832-9237
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 |
|---|---|---|---|
| 2043 | MA | MD | Psychologist |
| 202785 | MA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1295395200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1629373873",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "41 OAK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052730",
"telephone_number": "508-832-9237"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "41 OAK AVE",
"city": "WORCESTER",
"state": "MA",
"postal_code": "016052730",
"telephone_number": "508-832-9237"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMITIS",
"first_name": "SUSAN",
"middle_name": "MARIE",
"name_prefix": "Ms.",
"credential": "M.A.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-01-19",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "2043",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "202785",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Worcester, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.