Provider Demographics
NPI:1407528748
Name:SIMPSON, JILLIAN NICOLE (LPC-A)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:NICOLE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LPC-A
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9415 PANTHER CREEK PKWY APT 225
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75035-1104
Mailing Address - Country:US
Mailing Address - Phone:469-886-3624
Mailing Address - Fax:
Practice Address - Street 1:3740 N JOSEY LN STE 145
Practice Address - Street 2:
Practice Address - City:CARROLLTON
Practice Address - State:TX
Practice Address - Zip Code:75007-2471
Practice Address - Country:US
Practice Address - Phone:469-701-2333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-05
Last Update Date:2021-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX86977101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional