Provider Demographics
NPI:1134914880
Name:SIMPSON, SHELLY A (MAC, PLPC)
Entity type:Individual
Prefix:
First Name:SHELLY
Middle Name:A
Last Name:SIMPSON
Suffix:
Gender:
Credentials:MAC, PLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6744 CLAYTON RD STE 221
Mailing Address - Street 2:
Mailing Address - City:RICHMOND HEIGHTS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-1634
Mailing Address - Country:US
Mailing Address - Phone:314-720-2710
Mailing Address - Fax:
Practice Address - Street 1:6744 CLAYTON RD STE 221
Practice Address - Street 2:
Practice Address - City:RICHMOND HEIGHTS
Practice Address - State:MO
Practice Address - Zip Code:63117-1634
Practice Address - Country:US
Practice Address - Phone:314-720-2710
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2024046024101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor