Provider Demographics
NPI:1083065544
Name:SIMPSON, HEATHER BROOKE (LCSW)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:BROOKE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2207 DELANEY DR
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27215-5263
Mailing Address - Country:US
Mailing Address - Phone:336-684-9951
Mailing Address - Fax:336-513-0554
Practice Address - Street 1:2207 DELANEY DR STE 107
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27215-5263
Practice Address - Country:US
Practice Address - Phone:336-270-9692
Practice Address - Fax:336-513-0554
Is Sole Proprietor?:No
Enumeration Date:2016-06-27
Last Update Date:2019-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0116441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCC011644OtherLCSW