Jeremy Scott Simon, MS, LCDC, LPC-I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

14709 Issued in TX

Practice address

756 Purple Sage Rd
Bandera, TX 78003

Phone

(844) 448-2567

NPI assigned

Mar 23, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Warriors Healing Center, LLC

  • Substance Abuse Rehabilitation Facility
  • Bandera, TX
  • NPI 1780048827
  NPD (past)

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1972189447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1503",
            "city": "FREDERICKSBURG",
            "state": "TX",
            "postal_code": "786241503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 PURPLE SAGE RD",
            "city": "BANDERA",
            "state": "TX",
            "postal_code": "78003",
            "telephone_number": "844-448-2567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "JEREMY",
        "middle_name": "SCOTT",
        "credential": "MS, LCDC, LPC-I",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "80898",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "14709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Lee Schmidt, D.O.
• Robert Schonhoff III, PA
• Rachel Schwartz, BCBA, TX-LBA
• Taylor Seymour-Newton, LPC-A, NCC
• Teresa Shaver, RN
• W Bryan Sims, DNP
• April Smith, MA, M.ED., CCC-SLP
• Southern Psychiatric Services LLC
• Sunrise Speech Therapy LLC
• Ted Sako DDS

• All providers in Bandera, TX
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.