Healthcare Provider Details

I. General information

NPI: 1902199722
Provider Name (Legal Business Name): KAREN ALICIA SIMPSON LCSW-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN ALICIA WILSON LCSW-C

II. Dates (important events)

Enumeration Date: 05/26/2011
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1546 PORTER ST RM 204A
FORT DETRICK MD
21702-9234
US

IV. Provider business mailing address

1301 PICCARD DR
ROCKVILLE MD
20850-4320
US

V. Phone/Fax

Practice location:
  • Phone: 301-619-8074
  • Fax:
Mailing address:
  • Phone: 240-777-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number13105
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: