Individual
RENEE SIMONE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN, LICSW, LADC I
Contact information
Practice address
71 MARY ST, CHICOPEE, MA 01020-1139
(413) 536-1918
(413) 536-8078
Mailing address
71 MARY ST STE 1802, CHICOPEE, MA 01020-1139
(919) 793-6862
(413) 315-8068
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
1181
MA
1041C0700X
Clinical Social Worker
111795
MA
363LP2300X
Primary Care Nurse Practitioner
Primary
7234
CT
363LP2300X
Primary Care Nurse Practitioner
MS1125839N
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1036490
NHP
MA
05
—
1053497206
—
CT
05
—
1853171
—
MA
01
—
2197528
CIGNA
MA
01
—
726247000
MAGELLAN
MA
01
—
861096515
AETNA
MA
01
—
P08297
BC/BS
MA
Enumeration date
10/31/2006
Last updated
05/29/2019
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