Active NPI
Eva Simon, MACP
- Professional Counselor
- Winooski, VT
National Provider Identifier
1861555922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 0680000358
- Practice address
- 20 West Canal St
Woolen Mill Offices
Winooski, VT 05404 - Phone
- (802) 863-3399
- NPI assigned
- Dec 19, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | 0680000358 | VT | Primary |
Addresses
Primary practice location
20 West Canal St
Woolen Mill Offices
Winooski, VT 05404
Mailing address
20 West Canal St
Woolen Mill Offices
Winooski, VT 05404
Phone (802) 863-3399
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1010824 | Medicaid | VT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0680000358 | VT | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1166486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1861555922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "20 WEST CANAL ST",
"address_2": "WOOLEN MILL OFFICES",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "05404",
"telephone_number": "802-863-3399"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 WEST CANAL ST",
"address_2": "WOOLEN MILL OFFICES",
"city": "WINOOSKI",
"state": "VT",
"postal_code": "05404",
"telephone_number": "802-863-3399"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SIMON",
"first_name": "EVA",
"name_prefix": "Ms.",
"credential": "MACP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-12-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "VT",
"license": "0680000358",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1010824",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Winooski, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.