Provider Demographics
NPI:1760642342
Name:SIMPSON, KRISTEN E (MS)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:E
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1001 SAINT PAUL ST
Mailing Address - Street 2:2G
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2640
Mailing Address - Country:US
Mailing Address - Phone:586-873-0788
Mailing Address - Fax:
Practice Address - Street 1:611 PARK AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21201-4572
Practice Address - Country:US
Practice Address - Phone:586-873-0788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDA0037103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist