Provider Demographics
NPI:1609487925
Name:SIMPSON, CHANDLER DESHAZO (LCMHCA, NCC)
Entity Type:Individual
Prefix:MRS
First Name:CHANDLER
Middle Name:DESHAZO
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LCMHCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:831 LOCKESLEY LN
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27217-8733
Mailing Address - Country:US
Mailing Address - Phone:919-949-1627
Mailing Address - Fax:
Practice Address - Street 1:530 ROSENWALD ST
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:NC
Practice Address - Zip Code:27217-2468
Practice Address - Country:US
Practice Address - Phone:919-949-1627
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-11
Last Update Date:2020-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA14020101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health