Provider Demographics
NPI:1720052137
Name:SIMPSON, JONI (M ED, L P C)
Entity Type:Individual
Prefix:
First Name:JONI
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:M ED, L P C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 84213
Mailing Address - Street 2:
Mailing Address - City:FAIRBANKS
Mailing Address - State:AK
Mailing Address - Zip Code:99708-4213
Mailing Address - Country:US
Mailing Address - Phone:907-474-8116
Mailing Address - Fax:907-474-8116
Practice Address - Street 1:1405 KELLUM ST
Practice Address - Street 2:
Practice Address - City:FAIRBANKS
Practice Address - State:AK
Practice Address - Zip Code:99701-4102
Practice Address - Country:US
Practice Address - Phone:907-479-3171
Practice Address - Fax:907-458-9042
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional