Individual
LARRY MARK SIMON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MHC
Contact information
Practice address
68 CUMBERLAND ST, SUITE 102, WOONSOCKET, RI 02895-3323
(401) 356-1940
(401) 356-1949
Mailing address
68 CUMBERLAND ST, SUITE 102, WOONSOCKET, RI 02895-3323
(401) 356-1940
(401) 356-1949
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00146
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
233219
BLUE CROSS BLUE SHIELD
RI
01
—
408993
BLUE CHIP
RI
01
—
470076
TUFTS
RI
01
—
6267131
UNITED HEALTH CARE
RI
05
—
LS40876
—
RI
Enumeration date
09/20/2006
Last updated
06/04/2024
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