Provider Demographics
NPI:1437433059
Name:SIMPSON-DAVIS, RISA L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:RISA
Middle Name:L
Last Name:SIMPSON-DAVIS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 BEAUVOIR AVE
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3568
Mailing Address - Country:US
Mailing Address - Phone:908-522-4800
Mailing Address - Fax:908-522-4888
Practice Address - Street 1:46 BEAUVOIR AVE
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07902-3568
Practice Address - Country:US
Practice Address - Phone:908-522-4800
Practice Address - Fax:908-522-4888
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-30
Last Update Date:2011-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054678001041C0700X
NJ1041C0700X1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical