Healthcare Provider Details

I. General information

NPI: 1457838302
Provider Name (Legal Business Name): TABITHA SIMPSON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2018
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2460 GARDNERSVILLE RD
CRITTENDEN KY
41030-8239
US

IV. Provider business mailing address

2460 GARDNERSVILLE RD
CRITTENDEN KY
41030-8239
US

V. Phone/Fax

Practice location:
  • Phone: 937-213-3024
  • Fax:
Mailing address:
  • Phone: 937-213-3024
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number258644
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number253404
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: