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Individual

CAROLYN JEAN SIMON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPC

Contact information

Practice address
26522 VAN DYKE AVE, CENTER LINE, MI 48015-1221
(586) 759-4400
(586) 759-4401
Mailing address
27009 FARMBROOK VILLA DR, SOUTHFIELD, MI 48034-1041
(248) 470-9959

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
6401012669
MI
101YP1600X
Pastoral Counselor
6401012669
MI
101YP2500X
Professional Counselor
Primary
64011012669
MI

Other

Enumeration date
02/02/2012
Last updated
03/17/2018
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