Provider Demographics
NPI:1801003041
Name:SIMPSON, BRAD KENDALL (MFT)
Entity Type:Individual
Prefix:MR
First Name:BRAD
Middle Name:KENDALL
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:295 ROYAL LEGACY LN
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89110-5260
Mailing Address - Country:US
Mailing Address - Phone:702-453-4856
Mailing Address - Fax:
Practice Address - Street 1:295 ROYAL LEGACY LN
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89110-5260
Practice Address - Country:US
Practice Address - Phone:702-453-4856
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV0638106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist