Provider Demographics
NPI:1073089306
Name:SIMPSON, VALENCIA NICOLE
Entity Type:Individual
Prefix:MS
First Name:VALENCIA
Middle Name:NICOLE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:VALENCIA
Other - Middle Name:NICOLE
Other - Last Name:SINGLETON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:995 DUXBERRY AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43211-2134
Mailing Address - Country:US
Mailing Address - Phone:614-738-4817
Mailing Address - Fax:
Practice Address - Street 1:995 DUXBERRY AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43211-2134
Practice Address - Country:US
Practice Address - Phone:614-738-4817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-14
Last Update Date:2023-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes323P00000XResidential Treatment FacilitiesPsychiatric Residential Treatment Facility
No385HR2065XRespite Care FacilityRespite CareRespite Care, Physical Disabilities, Child
Yes385HR2060XRespite Care FacilityRespite CareRespite Care, Intellectual and/or Developmental Disabilities, Child
No385H00000XRespite Care FacilityRespite Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0268420Medicaid