Provider Demographics
NPI:1023143591
Name:SIMONS, CORRINE (MSW)
Entity type:Individual
Prefix:MISS
First Name:CORRINE
Middle Name:
Last Name:SIMONS
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6716
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-0416
Mailing Address - Country:US
Mailing Address - Phone:202-302-8609
Mailing Address - Fax:202-562-0576
Practice Address - Street 1:4409 S CAPITOL ST SW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20032-2107
Practice Address - Country:US
Practice Address - Phone:202-373-1815
Practice Address - Fax:202-562-0576
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAB23135101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)