Healthcare Provider Details

I. General information

NPI: 1710622816
Provider Name (Legal Business Name): BRETT A SIMPSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2022
Last Update Date: 09/10/2026
Certification Date: 09/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

324 SOUTHVIEW DR
NICHOLASVILLE KY
40356-2008
US

IV. Provider business mailing address

1351 NEWTOWN PIKE BLDG 1
LEXINGTON KY
40511-1277
US

V. Phone/Fax

Practice location:
  • Phone: 859-885-6315
  • Fax:
Mailing address:
  • Phone: 859-253-1686
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW00001683
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: