Provider Demographics
NPI:1356526354
Name:SIMPSON, JANIE M (LCSW)
Entity type:Individual
Prefix:
First Name:JANIE
Middle Name:M
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1724 VILLAGE WAY STE A
Mailing Address - Street 2:
Mailing Address - City:ORANGE PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32073-5264
Mailing Address - Country:US
Mailing Address - Phone:904-269-0886
Mailing Address - Fax:
Practice Address - Street 1:1724 VILLAGE WAY STE A
Practice Address - Street 2:
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32073-5264
Practice Address - Country:US
Practice Address - Phone:904-269-0886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW3792101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health