| Susan Goryeb Simms, Licensed Clinical Social Worker, Pc | |
|
710 Main St Port Jefferson NY 11777-2278 | |
| (516) 946-3495 | |
| Not Available |
| Full Name | Susan Goryeb Simms, Licensed Clinical Social Worker, Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 710 Main St, Port Jefferson, New York |
| Authorized Official Name and Position | Susan Simms (OWNER) |
| Authorized Official Contact | 5169463495 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Susan Goryeb Simms, Licensed Clinical Social Worker, Pc 16 Storybook Ln East Setauket NY 11733-1727 Ph: (516) 946-3495 | Susan Goryeb Simms, Licensed Clinical Social Worker, Pc 710 Main St Port Jefferson NY 11777-2278 Ph: (516) 946-3495 |
| NPI Number | 1821694928 |
|---|---|
| Provider Enumeration Date | 12/05/2020 |
| Last Update Date | 12/05/2020 |
| Certification Date | 12/05/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821694928 | NPI | - | NPPES |
| 05191231 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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