Provider Demographics
NPI:1871187179
Name:SIMPSON, KIM (MLSW)
Entity Type:Individual
Prefix:MS
First Name:KIM
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:MLSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:134 MAPLE HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-2328
Mailing Address - Country:US
Mailing Address - Phone:302-287-6943
Mailing Address - Fax:
Practice Address - Street 1:320 N HIGH STREET EXTENDED
Practice Address - Street 2:
Practice Address - City:SMYRNA
Practice Address - State:DE
Practice Address - Zip Code:19977-1183
Practice Address - Country:US
Practice Address - Phone:302-659-5060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-26
Last Update Date:2021-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ3-0000214101YP1600X, 104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YP1600XBehavioral Health & Social Service ProvidersCounselorPastoral