Provider Demographics
NPI:1124416771
Name:SIMPSON, EARNESTINE WILLIAMS (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:EARNESTINE
Middle Name:WILLIAMS
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 ROUTE 130 S BLDG SUITE9
Mailing Address - Street 2:
Mailing Address - City:CINNAMINSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08077-2845
Mailing Address - Country:US
Mailing Address - Phone:856-866-8795
Mailing Address - Fax:
Practice Address - Street 1:101 ROUTE 130 S BLDG SUITE9
Practice Address - Street 2:
Practice Address - City:CINNAMINSON
Practice Address - State:NJ
Practice Address - Zip Code:08077-2845
Practice Address - Country:US
Practice Address - Phone:856-866-8795
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-01-06
Last Update Date:2019-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO45708001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0020516Medicaid