Provider Demographics
NPI:1801036298
Name:SIMPSON, MARY ASHLEY (ALC)
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:ASHLEY
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:29000 HIGHWAY 98
Mailing Address - Street 2:STE A203
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7272
Mailing Address - Country:US
Mailing Address - Phone:251-626-5797
Mailing Address - Fax:251-626-5798
Practice Address - Street 1:29000 HIGHWAY 98
Practice Address - Street 2:STE A203
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7272
Practice Address - Country:US
Practice Address - Phone:251-626-5797
Practice Address - Fax:251-626-5798
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-25
Last Update Date:2009-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALC1058A101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)