Organization
JONATHAN ALAN SIMONS PHD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. PATRICIA CLAIRE STELLING (VICE PRESIDENT-OFFICE MANAGER)
(843) 828-0502
Entity
Organization
Contact information
Practice address
1506 AZALEA DR, STE 602, SURFSIDE BEACH, SC 29575-5232
(843) 828-0502
(843) 828-4402
Mailing address
PO BOX 859, PAWLEYS ISLAND, SC 29585-0859
(843) 828-0502
(843) 828-4402
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
639
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PS0245
—
SC
Enumeration date
05/02/2007
Last updated
08/23/2012
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