Provider Demographics
NPI:1477072627
Name:SIMPSON, H. WAYNE (LAC 729)
Entity Type:Individual
Prefix:
First Name:H.
Middle Name:WAYNE
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:LAC 729
Other - Prefix:
Other - First Name:H
Other - Middle Name:WAYNE
Other - Last Name:SIMSPN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LAC 719
Mailing Address - Street 1:3835 W DOUGLAS AVE
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67213-2408
Mailing Address - Country:US
Mailing Address - Phone:316-941-9948
Mailing Address - Fax:
Practice Address - Street 1:3835 W DOUGLAS AVE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67213-2408
Practice Address - Country:US
Practice Address - Phone:316-941-9948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-09-19
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)