Provider Demographics
NPI:1477010601
Name:SIMPSON, TANNER JAMES (PSYD)
Entity Type:Individual
Prefix:
First Name:TANNER
Middle Name:JAMES
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 HOYT ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80215-1639
Mailing Address - Country:US
Mailing Address - Phone:720-399-9258
Mailing Address - Fax:
Practice Address - Street 1:2001 HOYT ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80215-1639
Practice Address - Country:US
Practice Address - Phone:720-399-9258
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-24
Last Update Date:2021-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103TS0200X, 103T00000X
CO00014485103T00000X
CO357926103TS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TS0200XBehavioral Health & Social Service ProvidersPsychologistSchool