Provider Demographics
NPI:1184655607
Name:SIMPSON, SARA M (LPC)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:M
Last Name:SIMPSON
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 1:1011 W 31ST ST
Mailing Address - Street 2:SUITE 515
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78705
Mailing Address - Country:US
Mailing Address - Phone:512-302-4788
Mailing Address - Fax:512-458-4569
Practice Address - Street 1:1011 W 31ST ST
Practice Address - Street 2:SUITE 515
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78705
Practice Address - Country:US
Practice Address - Phone:512-302-4788
Practice Address - Fax:512-458-4569
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14534101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXLP0036413Medicaid
3654LCOtherBLUE CROSS