Provider Demographics
NPI:1285208785
Name:ROESCH-SIMPSON, SILVIA LIANE (LPC)
Entity Type:Individual
Prefix:
First Name:SILVIA
Middle Name:LIANE
Last Name:ROESCH-SIMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:SILVIA
Other - Middle Name:LIANE
Other - Last Name:SIMPSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPC
Mailing Address - Street 1:4704 SHAWN DR
Mailing Address - Street 2:
Mailing Address - City:KILLEEN
Mailing Address - State:TX
Mailing Address - Zip Code:76542-8434
Mailing Address - Country:US
Mailing Address - Phone:254-813-6614
Mailing Address - Fax:
Practice Address - Street 1:4304 E CENTRAL TEXAS EXPY
Practice Address - Street 2:
Practice Address - City:KILLEEN
Practice Address - State:TX
Practice Address - Zip Code:76543-7308
Practice Address - Country:US
Practice Address - Phone:254-638-8680
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-18
Last Update Date:2021-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX79931101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional