Provider Demographics
NPI:1922709690
Name:SIMPSON, LISA M (LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:M
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1310 W HAYS ST
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83702-5025
Mailing Address - Country:US
Mailing Address - Phone:208-871-5733
Mailing Address - Fax:815-642-8484
Practice Address - Street 1:1310 W HAYS ST
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83702-5025
Practice Address - Country:US
Practice Address - Phone:208-871-5733
Practice Address - Fax:815-642-8484
Is Sole Proprietor?:No
Enumeration Date:2023-03-10
Last Update Date:2023-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLPC-9007101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional