Provider Demographics
NPI:1568742344
Name:SIMPSON, ALTHEA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALTHEA
Middle Name:
Last Name:SIMPSON
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 1:12781 DARBY BROOK CT
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAKE RIDGE
Mailing Address - State:VA
Mailing Address - Zip Code:22192-2482
Mailing Address - Country:US
Mailing Address - Phone:703-595-6988
Mailing Address - Fax:
Practice Address - Street 1:12781 DARBY BROOK CT
Practice Address - Street 2:SUITE 201
Practice Address - City:LAKE RIDGE
Practice Address - State:VA
Practice Address - Zip Code:22192-2482
Practice Address - Country:US
Practice Address - Phone:703-595-6988
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-24
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040075071041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical