Healthcare Provider Details

I. General information

NPI: 1376057018
Provider Name (Legal Business Name): JACQUELINE SIMPKINS MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/16/2017
Last Update Date: 11/16/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 LENFANT SQ SE
WASHINGTON DC
20020-6724
US

IV. Provider business mailing address

1301 LENFANT SQ SE
WASHINGTON DC
20020-6724
US

V. Phone/Fax

Practice location:
  • Phone: 202-584-1244
  • Fax:
Mailing address:
  • Phone: 202-584-1244
  • Fax: 202-584-1248

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberLG102438
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: