Provider Demographics
NPI:1386134021
Name:SIMPSIRIDIS, LAURALEE (PMHNP-BC, ALC)
Entity type:Individual
Prefix:MRS
First Name:LAURALEE
Middle Name:
Last Name:SIMPSIRIDIS
Suffix:
Gender:F
Credentials:PMHNP-BC, ALC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28080 US HIGHWAY 98 STE C
Mailing Address - Street 2:
Mailing Address - City:DAPHNE
Mailing Address - State:AL
Mailing Address - Zip Code:36526-7012
Mailing Address - Country:US
Mailing Address - Phone:251-325-1402
Mailing Address - Fax:
Practice Address - Street 1:28080 US HIGHWAY 98 STE C
Practice Address - Street 2:
Practice Address - City:DAPHNE
Practice Address - State:AL
Practice Address - Zip Code:36526-7012
Practice Address - Country:US
Practice Address - Phone:251-325-1402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-05-17
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-098628363LP0808X
ALALC04534101YM0800X
MS902612363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health