Provider Demographics
NPI:1982954269
Name:SIMSON, WYNN AND WILLIAMS
Entity Type:Organization
Organization Name:SIMSON, WYNN AND WILLIAMS
Other - Org Name:WELCOME
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:SALLY
Authorized Official - Middle Name:
Authorized Official - Last Name:WYNN
Authorized Official - Suffix:
Authorized Official - Credentials:DRAD
Authorized Official - Phone:916-476-6301
Mailing Address - Street 1:7844 MADISON AVE.,
Mailing Address - Street 2:SUITE 106
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628
Mailing Address - Country:US
Mailing Address - Phone:916-476-6301
Mailing Address - Fax:
Practice Address - Street 1:7844 MADISON AVE.,
Practice Address - Street 2:SUITE 106
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628
Practice Address - Country:US
Practice Address - Phone:916-476-6301
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-09-14
Last Update Date:2012-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARAS #W0702211501101YA0400X
CAMFT28031101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty