Provider Demographics
NPI:1235533282
Name:SIMPSON, LATOYA MONIQUE (LCSWA)
Entity Type:Individual
Prefix:
First Name:LATOYA
Middle Name:MONIQUE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LCSWA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1023 US HIGHWAY 17 S
Mailing Address - Street 2:
Mailing Address - City:ELIZABETH CITY
Mailing Address - State:NC
Mailing Address - Zip Code:27909-9070
Mailing Address - Country:US
Mailing Address - Phone:252-321-1726
Mailing Address - Fax:
Practice Address - Street 1:1023 US HIGHWAY 17 S
Practice Address - Street 2:
Practice Address - City:ELIZABETH CITY
Practice Address - State:NC
Practice Address - Zip Code:27909-9070
Practice Address - Country:US
Practice Address - Phone:252-321-1726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-20
Last Update Date:2023-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCP0196841041C0700X
NC16058101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical