Tola Simeon | Staten Island, NY • PECOS Search

Tola Simeon

Social Worker

Behavioral Health & Social Service Providers

194 Targee St, Staten Island, NY 10304-1926

(718) 390-0561 (347) 857-0775

PECOS Enrollment

Based on the most recent information from CMS, provider Tola Simeon does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1467731810
Provider Type
Individual
Full Name
Simeon, Tola
Credential
LMSW

Gender
Female
Sole Proprietor
No
Enumeration Date
8/16/2011
Last Updated
8/16/2011

Contact Information

Practice Location

194 Targee St, Staten Island, NY 10304-1926

(718) 390-5166

Mailing Location

84b Andros Ave, Staten Island, NY 10303-2047

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 104100000X Primary	Description Social Worker Behavioral Health & Social Service Providers	License 071435-1 New York