Individual provider Active NPI

Donna Marie Simon, LCSW, BCBA

  • Behavior Analyst
  • Wall Township, NJ
National Provider Identifier
1689133654
Registry record updated Sep 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
License
1-16-23168 Issued in NU
Practice address
2510 Belmar Blvd Unit 19 2ND FL
Wall Township, NJ 07719
Phone
(631) 213-5102
NPI assigned
Mar 18, 2019
Last updated
Sep 16, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 44SC06107100 NJ
Behavior Analyst 103K00000X 1-16-23168 NU Primary

Addresses

Primary practice location

2510 Belmar Blvd Unit 19 2ND FL
Wall Township, NJ 07719

Mailing address

915 Bennetts Mills Rd Unit 705
Jackson, NJ 08527-8008
Phone (631) 213-5102

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
44SC06107100NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
New Perspective Therapy Clinical Current Accepting new patients
Step by Step Behavioral Therapy, LLC Behavior Analyst CurrentSince Apr 1, 2022 Accepting new patients

Locations

915 Bennetts Mills Rd
Unit 705
Jackson, NJ 08527

Organizations & group practices 2

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663286400000",
    "number": "1689133654",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "915 BENNETTS MILLS RD UNIT 705",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085278008",
            "telephone_number": "631-213-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2510 BELMAR BLVD UNIT 19 2ND FL",
            "city": "WALL TOWNSHIP",
            "state": "NJ",
            "postal_code": "07719",
            "telephone_number": "631-213-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "DONNA",
        "middle_name": "MARIE",
        "name_prefix": "Ms.",
        "credential": "LCSW, BCBA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-18",
        "last_updated": "2022-09-16",
        "certification_date": "2022-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06107100",
            "primary": false
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "NU",
            "license": "1-16-23168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wall Township, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2022; 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.