Individual
THOMAS SIMEK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PSYCHOLOGIST-MA
Contact information
Practice address
100 LEDGEHILL RD, BENNINGTON, VT 05201-2273
(802) 442-5491
(802) 442-4910
Mailing address
PO BOX 588, BENNINGTON, VT 05201-0588
(802) 442-5491
(802) 442-4910
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
047-0000388
VT
101YA0400X
Addiction (Substance Use Disorder) Counselor
000232
VT
103T00000X
Psychologist
Primary
0470000388
VT
103TA0400X
Addiction (Substance Use Disorder) Psychologist
000232
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0VN1870
—
VT
01
—
1041845
CIGNA
—
01
—
29291
BLUE CROSS
—
01
—
359413
MANAGED HEALTH NET
—
Enumeration date
07/21/2006
Last updated
03/21/2008
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