MEDICARE: CHRISTINE SIMPSON MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	C002357	NC

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	32453	OTHER	NC	BLUE CROSS BLUE SHIELD
2	2669	OTHER	NC	CBHA
3	92973989	OTHER	NC	UNITED BEHAVIORAL HEALTH
4	1163257	OTHER	NC	CIGNA

General Provider Information

NPI Number	:	1710940226
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINE SIMPSON MSW

Provider Business Mailing Address
First Line	:	3315 SPRINGBANK LN STE 302
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3198
Country	:	US
Telephone Number	:	704-288-0314
Fax Number	:	704-288-0310

Provider Business Practice Location Address
First Line	:	3315 SPRINGBANK LN STE 302
Second Line	:
City	:	CHARLOTTE
State	:	NC
Zip	:	28226-3198
Country	:	US
Telephone Number	:	704-288-0314
Fax Number	:	704-288-0310

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/07/2006
Last Update Date	:	09/30/2024

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