| Jonathan Alan Simons Phd Pc | |
|
1506 Azalea Dr Ste 602 Surfside Beach SC 29575-5232 | |
| (843) 828-0502 | |
| (843) 828-4402 |
| Full Name | Jonathan Alan Simons Phd Pc |
|---|---|
| Speciality | Psychologist - Clinical |
| Location | 1506 Azalea Dr, Surfside Beach, South Carolina |
| Authorized Official Name and Position | Patricia Claire Stelling (VICE PRESIDENT-OFFICE MANAGER) |
| Authorized Official Contact | 8438280502 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jonathan Alan Simons Phd Pc Po Box 859 Pawleys Island SC 29585-0859 Ph: (843) 828-0502 | Jonathan Alan Simons Phd Pc 1506 Azalea Dr Ste 602 Surfside Beach SC 29575-5232 Ph: (843) 828-0502 |
| NPI Number | 1104048925 |
|---|---|
| Provider Enumeration Date | 05/02/2007 |
| Last Update Date | 08/23/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104048925 | NPI | - | NPPES |
| PS0245 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 103TC0700X | Psychologist - Clinical | 639 (South Carolina) | Primary |
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