Individual
MARY L. SIMBARCELOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, LPC
Contact information
Practice address
431 W. PINE ST., PINEDALE, WY 82941
(402) 525-7509
(307) 367-2864
Mailing address
PO BOX 1641, PINEDALE, WY 82941-1641
(402) 525-7509
(307) 367-2864
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
405
NE
101YM0800X
Mental Health Counselor
Primary
1381
WY
102L00000X
Psychoanalyst
1799
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10025915300
—
NE
01
—
710765000
MAGELLAN
NE
Enumeration date
03/04/2011
Last updated
01/26/2018
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