Stacey Simon, MA, LCDP, ICADC, MHS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

CD-0000082 Issued in DE

Practice address

505 W Market St
Suite 110
Georgetown, DE 19947-2344

Phone

(302) 854-0626

NPI assigned

Jan 17, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fellowship Health Resources, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Lincoln, RI
  • NPI 1245239680
  NPD (past)

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

{
    "created_epoch": "1484611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484611200000",
    "number": "1699211490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30716 CYPRESS LN",
            "city": "LAUREL",
            "state": "DE",
            "postal_code": "199563514",
            "telephone_number": "302-381-8483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 W MARKET ST",
            "address_2": "SUITE 110",
            "city": "GEORGETOWN",
            "state": "DE",
            "postal_code": "199472344",
            "telephone_number": "302-854-0626"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "STACEY",
        "name_prefix": "Mrs.",
        "credential": "MA, LCDP, ICADC, MHS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-17",
        "last_updated": "2017-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "DE",
            "license": "CD-0000082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delaney Brooke Sears, RDH
• Shawnee Seitz
• Meghan Elizabeth Shand
• Amber L Sharp, APRN
• Briana G Shuman, COTA
• Parul Singh, M.D.
• Alexandra Skidmore
• Brenda R Smith, LPCMH, NCC
• Julie Smith
• Myrna Lee Smith, APN

• Addiction (Substance Use Disorder) Counselor in Georgetown, DE
• Providers in Georgetown, DE by specialty
• Addiction (Substance Use Disorder) Counselor in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2017; 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.