Provider Demographics
NPI:1659975662
Name:JOSHUA SIMPSON LISAC PLLC
Entity Type:Organization
Organization Name:JOSHUA SIMPSON LISAC PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LISAC
Authorized Official - Prefix:
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:480-395-2347
Mailing Address - Street 1:1515 N GILBERT RD STE 107
Mailing Address - Street 2:#114
Mailing Address - City:GILBERT
Mailing Address - State:AZ
Mailing Address - Zip Code:85234
Mailing Address - Country:US
Mailing Address - Phone:480-395-2347
Mailing Address - Fax:
Practice Address - Street 1:1515 N GILBERT RD STE 107
Practice Address - Street 2:#114
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85234
Practice Address - Country:US
Practice Address - Phone:480-395-2347
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-30
Last Update Date:2020-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health