Healthcare Provider Details
I. General information
NPI: 1861202186
Provider Name (Legal Business Name): SHERESE LASHAWN SIMPSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 01/09/2025
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
5201 CONNECTICUT AVE NW APT 409
WASHINGTON DC
20015-1858
US
IV. Provider business mailing address
1106 COLUMBIA RD NW APT 202
WASHINGTON DC
20009-5352
US
V. Phone/Fax
- Phone: 202-847-7307
- Fax:
- Phone: 202-847-7307
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 106S00000X |
| Taxonomy | Behavior Technician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 3747P1801X |
| Taxonomy | Personal Care Attendant |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: