Provider Demographics
NPI:1710423322
Name:SIMPSON, KATHLEEN (LSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 SPRINGFIELD CIR
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:IN
Mailing Address - Zip Code:46143-7710
Mailing Address - Country:US
Mailing Address - Phone:317-833-4999
Mailing Address - Fax:
Practice Address - Street 1:389 SPRINGFIELD CIR
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-7710
Practice Address - Country:US
Practice Address - Phone:317-833-4999
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-06
Last Update Date:2017-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33007741A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker