Healthcare Provider Details

I. General information

NPI: 1679493803
Provider Name (Legal Business Name): CRAIG SIMPSON BCBA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2026
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4071 ADAMS DR
SILVER SPRING MD
20902-2357
US

IV. Provider business mailing address

4071 ADAMS DR
SILVER SPRING MD
20902-2357
US

V. Phone/Fax

Practice location:
  • Phone: 204-505-8408
  • Fax:
Mailing address:
  • Phone: 204-505-8408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License NumberLBA2720
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: