1457804155 NPI number — PATRICIA A. SIMPSON, LCSW, BCD LLC

Table of content: (NPI 1457804155)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1457804155 NPI number — PATRICIA A. SIMPSON, LCSW, BCD LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PATRICIA A. SIMPSON, LCSW, BCD LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1457804155
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/28/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 447
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HICKORY
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
15340-0447
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
724-356-4449
Provider Business Mailing Address Fax Number:
724-356-4432

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
60 MAIN STREET
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HICKORY
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
15340-0447
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
724-356-4449
Provider Business Practice Location Address Fax Number:
724-356-4432
Provider Enumeration Date:
07/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
SIMPSON
Authorized Official First Name:
PATRICIA
Authorized Official Middle Name:
ANN
Authorized Official Title or Position:
SOLE OWNER
Authorized Official Telephone Number:
724-356-4449

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  CW005217L , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 12516242 . This is a "MULTIPLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 250857000 . This is a "MAGELLAN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 117688 . This is a "VBH-PA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 70452561 . This is a "OPTUM UNITED BEHAVIORAL HEALTH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: SI831951 . This is a "HIGHMARK BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 104398 . This is a "UPMC" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 324423 . This is a "MHN" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 11410204 . This is a "CAQH" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".
  • Identifier: 0018612100001 , issued by the state of ( PA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 7563290 . This is a "AETNA" identifier , issued by the state of ( PA ) . This identifiers is of the category "OTHER".




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