Provider Demographics
NPI:1346061066
Name:CASSANDRA SIMPSON, LPC, LLC
Entity type:Organization
Organization Name:CASSANDRA SIMPSON, LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CASSANDRA
Authorized Official - Middle Name:SIMPSON
Authorized Official - Last Name:SIMPSON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:276-920-9900
Mailing Address - Street 1:635 S 1ST ST
Mailing Address - Street 2:
Mailing Address - City:WYTHEVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24382-3103
Mailing Address - Country:US
Mailing Address - Phone:276-920-9900
Mailing Address - Fax:
Practice Address - Street 1:635 S 1ST ST
Practice Address - Street 2:
Practice Address - City:WYTHEVILLE
Practice Address - State:VA
Practice Address - Zip Code:24382-3103
Practice Address - Country:US
Practice Address - Phone:276-920-9900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-10-24
Last Update Date:2024-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health