Healthcare Provider Details

I. General information

NPI: 1952517377
Provider Name (Legal Business Name): ZILLA SIMPSON LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/15/2007
Last Update Date: 09/26/2024
Certification Date: 09/12/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4800 W FLAGLER ST STE 215
CORAL GABLES FL
33134-1402
US

IV. Provider business mailing address

PO BOX 227841
DORAL FL
33222-7841
US

V. Phone/Fax

Practice location:
  • Phone: 954-368-4786
  • Fax: 954-368-4101
Mailing address:
  • Phone: 786-285-6805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH9315
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberMH9315
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: