Provider Demographics
NPI:1093362139
Name:SIMPKINS, SARA A (LPC)
Entity Type:Individual
Prefix:
First Name:SARA
Middle Name:A
Last Name:SIMPKINS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1139 NEWMARK ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97459-2450
Mailing Address - Country:US
Mailing Address - Phone:405-819-4457
Mailing Address - Fax:
Practice Address - Street 1:2323 PACIFIC AVE
Practice Address - Street 2:
Practice Address - City:NORTH BEND
Practice Address - State:OR
Practice Address - Zip Code:97459-2605
Practice Address - Country:US
Practice Address - Phone:541-404-5328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC011630101YM0800X
ORC6713101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health