Provider Demographics
NPI:1518045699
Name:SIMPSON, CRAIG BRADLEY (CERTIFIED SOCIAL WOR)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:BRADLEY
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:CERTIFIED SOCIAL WOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5770 S 1500 W
Mailing Address - Street 2:
Mailing Address - City:TAYLORSVILLE
Mailing Address - State:UT
Mailing Address - Zip Code:84123-5216
Mailing Address - Country:US
Mailing Address - Phone:801-313-7982
Mailing Address - Fax:
Practice Address - Street 1:497 COLOROW DR
Practice Address - Street 2:
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84108-1232
Practice Address - Country:US
Practice Address - Phone:801-662-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-02
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT2282984-35011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical