Marjorie Lorraine Berry Simon, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

115397 Issued in CA

Practice address

170 Alameda de Las Pulgas
Redwood City, CA 94062-2751

Phone

(650) 367-5636

NPI assigned

Mar 2, 2011

Last updated

Oct 2, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Marjorie Lorraine Berry Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marjorie.berrysimon@5337587187716.direct.elationemr.com

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.

• A Mindful Spot, a Licensed Clinical Social Worker PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
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  • NPI 1619828779
  NPD Authorized official
• Community Research Foundation Inc

  dba New Vistas

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1346463932
  NPD (past)
• Community Research Foundation Inc

  • Community/Behavioral Health Agency
  • San Diego, CA
  • NPI 1952328700

  Clinical

  NPD (past)

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1639477532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 152803",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921952803",
            "telephone_number": "619-771-2181"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 ALAMEDA DE LAS PULGAS",
            "city": "REDWOOD CITY",
            "state": "CA",
            "postal_code": "940622751",
            "telephone_number": "650-367-5636"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "PO Box 152803",
            "address_purpose": "LOCATION",
            "city": "San Diego",
            "state": "CA",
            "postal_code": "921952803",
            "country_code": "US",
            "telephone_number": "619-771-2181",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BERRY SIMON",
        "first_name": "MARJORIE",
        "middle_name": "LORRAINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-03-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "33331",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "115397",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": "93781",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARJORIE",
            "last_name": "BERRY",
            "middle_name": "LORRAINE",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Bernhard a. Votteri MD, Inc
• Natazha Bernie, DPT
• Allan R. Bernstein, MD
• Ivan Pranil Bernstein, PA-C
• Kathleen A Berra, N.P.
• Batrica Besada
• Sara Beskalis
• Tamar Besson, NP
• Daniel B. Beugelmans, MD
• Andrea Beylen, M.A., P.T.

• Clinical Social Worker in Redwood City, CA
• Providers in Redwood City, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.