Provider Demographics
NPI:1497523674
Name:SIMPSON, SHELBY (MED, NCC, PLPC)
Entity Type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MED, NCC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20334 HIGHWAY 1062
Mailing Address - Street 2:
Mailing Address - City:LORANGER
Mailing Address - State:LA
Mailing Address - Zip Code:70446-3514
Mailing Address - Country:US
Mailing Address - Phone:985-320-0689
Mailing Address - Fax:
Practice Address - Street 1:20334 HIGHWAY 1062
Practice Address - Street 2:
Practice Address - City:LORANGER
Practice Address - State:LA
Practice Address - Zip Code:70446-3514
Practice Address - Country:US
Practice Address - Phone:985-320-0689
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-12-18
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9953101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional