Provider Demographics
NPI:1467255018
Name:SIMPSON, AUDREY MADELINE (MA, LCMHCA)
Entity type:Individual
Prefix:
First Name:AUDREY
Middle Name:MADELINE
Last Name:SIMPSON
Suffix:
Gender:
Credentials:MA, LCMHCA
Other - Prefix:
Other - First Name:AUDREY
Other - Middle Name:MADELINE
Other - Last Name:COX
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7409 SECREST SHORTCUT RD
Mailing Address - Street 2:
Mailing Address - City:INDIAN TRAIL
Mailing Address - State:NC
Mailing Address - Zip Code:28079-8559
Mailing Address - Country:US
Mailing Address - Phone:980-298-3400
Mailing Address - Fax:
Practice Address - Street 1:1126 SAM NEWELL RD STE A
Practice Address - Street 2:
Practice Address - City:MATTHEWS
Practice Address - State:NC
Practice Address - Zip Code:28105-5084
Practice Address - Country:US
Practice Address - Phone:980-281-0911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-29
Last Update Date:2025-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA21226101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health