Provider Demographics
NPI:1235228701
Name:SIMPSON, RICKIE TOBIAS (PHD, PMHCNS-BC)
Entity Type:Individual
Prefix:DR
First Name:RICKIE
Middle Name:TOBIAS
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:PHD, PMHCNS-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9240B MOSBY ST
Mailing Address - Street 2:
Mailing Address - City:MANASSAS
Mailing Address - State:VA
Mailing Address - Zip Code:20110-5038
Mailing Address - Country:US
Mailing Address - Phone:703-335-1203
Mailing Address - Fax:703-335-1584
Practice Address - Street 1:9240B MOSBY ST
Practice Address - Street 2:
Practice Address - City:MANASSAS
Practice Address - State:VA
Practice Address - Zip Code:20110-5038
Practice Address - Country:US
Practice Address - Phone:703-335-1203
Practice Address - Fax:703-335-1584
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2015-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0015000665163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA163WP0809OtherPSYCHIATRIC/MENTAL HEALT,