Provider Demographics
NPI:1952517377
Name:SIMPSON, ZILLA (LMHC)
Entity type:Individual
Prefix:
First Name:ZILLA
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LMHC
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 227841
Mailing Address - Street 2:
Mailing Address - City:DORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33222-7841
Mailing Address - Country:US
Mailing Address - Phone:786-285-6805
Mailing Address - Fax:
Practice Address - Street 1:4800 W FLAGLER ST STE 215
Practice Address - Street 2:
Practice Address - City:CORAL GABLES
Practice Address - State:FL
Practice Address - Zip Code:33134-1402
Practice Address - Country:US
Practice Address - Phone:954-368-4786
Practice Address - Fax:954-368-4101
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2024-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH9315101YM0800X, 103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL122910800Medicaid
FL017563800Medicaid