Provider Demographics
NPI:1821625740
Name:SIMPSON, JOSHUA KEE (LISAC)
Entity Type:Individual
Prefix:
First Name:JOSHUA
Middle Name:KEE
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:LISAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
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:85234-2504
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:85234-2504
Practice Address - Country:US
Practice Address - Phone:480-395-2347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-23
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLISAC-15149101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)