Individual provider Active NPI

Simone Jalon-Main, PSY.D.

  • Psychologist
  • Rockville, MD
National Provider Identifier
1740703313
Registry record updated Nov 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
Practice address
402 King Farm Blvd
Suite 125-136
Rockville, MD 20850-5843
Phone
(202) 573-9297
NPI assigned
Jul 25, 2017
Last updated
Nov 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X NU Primary

Addresses

Primary practice location

402 King Farm Blvd
Suite 125-136
Rockville, MD 20850-5843

Mailing address

402 King Farm Blvd
Suite 125-136
Rockville, MD 20850-5843

Other practice location 1

4809 Jasmine Dr
Rockville, MD 20853-1743
Phone (215) 605-7918

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

Practice roles

OrganizationSpecialtyStatusNew patients
SJM Psychology, LLC CurrentSince Jan 1, 2022 Accepting new patients

Locations

402 King Farm Blvd
Ste 125136
Rockville, MD 20850
Phone (202) 573-9297

Organizations & group practices 1

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": "1500940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1669766400000",
    "number": "1740703313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "402 KING FARM BLVD",
            "address_2": "SUITE 125-136",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208505843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "402 KING FARM BLVD",
            "address_2": "SUITE 125-136",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208505843",
            "telephone_number": "202-573-9297"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4809 Jasmine Dr",
            "address_purpose": "LOCATION",
            "city": "Rockville",
            "state": "MD",
            "postal_code": "208531743",
            "country_code": "US",
            "telephone_number": "215-605-7918",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JALON-MAIN",
        "first_name": "SIMONE",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-25",
        "last_updated": "2022-11-30",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.