Individual provider · Type 1 NPI
Divine Hubert Simon
Peer Specialist · East Elmhurst, NY
NPI number
1205742095
Active
Practice location
10030 Ditmars Blvd
East Elmhurst, NY 11369-1333
Mailing address
3665 Bertha Dr
Baldwin, NY 11510-5035
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Peer Specialist Primary | 175T00000X | NYCPS-P-35993 (NY) |
Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.
4 other providers at this address
About NPI 1205742095
Divine Hubert Simon's National Provider Identifier is 1205742095, issued on Aug 20, 2026. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in East Elmhurst, NY. The record was last updated on Aug 20, 2026.