Provider Demographics
NPI:1962898429
Name:SIMPSON, ALICIA CHARLOTTE (LMSW)
Entity type:Individual
Prefix:
First Name:ALICIA
Middle Name:CHARLOTTE
Last Name:SIMPSON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 WAINWRIGHT PL
Mailing Address - Street 2:
Mailing Address - City:STRATFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06614-3247
Mailing Address - Country:US
Mailing Address - Phone:203-727-9818
Mailing Address - Fax:
Practice Address - Street 1:120 WAINWRIGHT PL
Practice Address - Street 2:
Practice Address - City:STRATFORD
Practice Address - State:CT
Practice Address - Zip Code:06614-3247
Practice Address - Country:US
Practice Address - Phone:203-727-9818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-11
Last Update Date:2015-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT11601041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical