Provider Demographics
NPI:1215242284
Name:SIMPSON, TRAVIS D
Entity type:Individual
Prefix:MR
First Name:TRAVIS
Middle Name:D
Last Name:SIMPSON
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 W 3000 N
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:UT
Mailing Address - Zip Code:84754-3270
Mailing Address - Country:US
Mailing Address - Phone:435-527-3191
Mailing Address - Fax:435-527-3076
Practice Address - Street 1:95 W 3000 N
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:UT
Practice Address - Zip Code:84754-3270
Practice Address - Country:US
Practice Address - Phone:435-527-3191
Practice Address - Fax:435-527-3076
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-13
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No253J00000XAgenciesFoster Care Agency