Provider Demographics
NPI:1013478148
Name:CIMPL, LINDA MARIE (MS,NCC,LPC-MH)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:MARIE
Last Name:CIMPL
Suffix:
Gender:F
Credentials:MS,NCC,LPC-MH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40808 256TH ST
Mailing Address - Street 2:
Mailing Address - City:MITCHELL
Mailing Address - State:SD
Mailing Address - Zip Code:57301-6206
Mailing Address - Country:US
Mailing Address - Phone:605-999-6162
Mailing Address - Fax:605-942-7300
Practice Address - Street 1:115 E HAVENS AVE STE 105
Practice Address - Street 2:
Practice Address - City:MITCHELL
Practice Address - State:SD
Practice Address - Zip Code:57301-4462
Practice Address - Country:US
Practice Address - Phone:605-999-6162
Practice Address - Fax:605-942-7300
Is Sole Proprietor?:Yes
Enumeration Date:2019-03-29
Last Update Date:2019-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDLPC-MH2321101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health