Victoria Simon, MA, LMSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

6801096752 Issued in MI

Practice address

105 S Saint Clair St
Port Sanilac, MI 48469-9657

Phone

(810) 434-9179

NPI assigned

Sep 29, 2015

Sex

Female

Sole proprietor

No

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.

• Emotional Evolution LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Sanilac, MI
  • NPI 1164270377
  NPD Authorized official
• Wellness Haven LLC

  • Counselor
  • Lexington, MI
  • NPI 1124709308
  NPD (past)

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

{
    "created_epoch": "1443484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1992175368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 S SAINT CLAIR ST",
            "city": "PORT SANILAC",
            "state": "MI",
            "postal_code": "484699657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 S SAINT CLAIR ST",
            "city": "PORT SANILAC",
            "state": "MI",
            "postal_code": "484699657",
            "telephone_number": "810-434-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "VICTORIA",
        "credential": "MA, LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-09-29",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6801096752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William Henry Noelke, MA, LPC, LMSW
• Carolyn Reish Richardson, BSN,RN
• Karen Marie Schulman, LMSW
• Mary Anne Simmons
• Thomas Alan Simmons, DDS
• Sarah May Smith
• Starfish Center, Inc
• Thomas a Simmons DDS Mary Anne Simmons DDS, PC

• Mental Health Counselor in Port Sanilac, MI
• Providers in Port Sanilac, MI by specialty
• Mental Health Counselor in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.