Provider Information for 1508365495
The following NPI(s) contain information matching your search criteria. Please select the NPI to view all the data associated with the NPI.
Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know
SIMONE E MACK LMHC
Sex: Female
NPI: 1508365495
Last Updated: 2021-02-12
Certification Date: 2021-02-12
Certification Date: 2021-02-12
Details
| Name | Value | ||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NPI | 1508365495 | ||||||||||||||||
| Enumeration Date | 2018-02-06 | ||||||||||||||||
| NPI Type | NPI-1 Individual | ||||||||||||||||
| Sole Proprietor | YES | ||||||||||||||||
| Status | Active | ||||||||||||||||
| Mailing Address | 17334 W SYCAMORE DR LOXAHATCHEE, FL 33470-5420 United States Phone: 561-336-1303 | Fax: | ||||||||||||||||
| Primary Practice Address | 1033 N CONGRESS AVE WEST PALM BEACH, FL 33409-5144 United States Phone: 561-386-8413 | Fax: | ||||||||||||||||
| Secondary Practice Address(es) | 17334 W. SYCAMORE DR. | ||||||||||||||||
| Health Information Exchange |
| ||||||||||||||||
| Other Identifiers |
| ||||||||||||||||
| Taxonomy |
|