Provider Demographics
NPI:1396496956
Name:SIMPSON, CHANEE ASHLEY (LPC)
Entity type:Individual
Prefix:
First Name:CHANEE
Middle Name:ASHLEY
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 1:6366 PRINCETON RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LITHONIA
Mailing Address - State:GA
Mailing Address - Zip Code:30058-6549
Mailing Address - Country:US
Mailing Address - Phone:845-536-1512
Mailing Address - Fax:
Practice Address - Street 1:2301 HENRY CLOWER BLVD STE A
Practice Address - Street 2:
Practice Address - City:SNELLVILLE
Practice Address - State:GA
Practice Address - Zip Code:30078-3152
Practice Address - Country:US
Practice Address - Phone:770-978-9393
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-15
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GALPC014823101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional