Provider Demographics
NPI:1982800496
Name:SIMPSON, G. A. JASON (PSYD)
Entity type:Individual
Prefix:DR
First Name:G. A. JASON
Middle Name:
Last Name:SIMPSON
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2288
Mailing Address - Street 2:
Mailing Address - City:FRISCO
Mailing Address - State:TX
Mailing Address - Zip Code:75034-0042
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2150 S CENTRAL EXPY
Practice Address - Street 2:SUITE 200
Practice Address - City:MCKINNEY
Practice Address - State:TX
Practice Address - Zip Code:75070-4070
Practice Address - Country:US
Practice Address - Phone:972-670-5153
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-22
Last Update Date:2016-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX31973103T00000X
IL071-006115103TC0700X
IN20041521103TH0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TH0004XBehavioral Health & Social Service ProvidersPsychologistHealth
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL208318Medicare ID - Type Unspecified