Healthcare Provider Details

I. General information

NPI: 1447531637
Provider Name (Legal Business Name): ANDREW LINK SIMPSON LPCA, NCC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/01/2011
Last Update Date: 09/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18515 STATESVILLE RD SUITE C-01
CORNELIUS NC
28031-5702
US

IV. Provider business mailing address

18515 STATESVILLE RD SUITE C-01
CORNELIUS NC
28031-5702
US

V. Phone/Fax

Practice location:
  • Phone: 704-860-0301
  • Fax:
Mailing address:
  • Phone: 704-860-0301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberA8725
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: