Healthcare Provider Details

I. General information

NPI: 1699538405
Provider Name (Legal Business Name): CINDY SIMPSON MA, LCMHCA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2024
Last Update Date: 02/05/2024
Certification Date: 02/03/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8801 FAST PARK DR STE 107
RALEIGH NC
27617-4853
US

IV. Provider business mailing address

1601 JONES FRANKLIN RD STE 104
RALEIGH NC
27606-3379
US

V. Phone/Fax

Practice location:
  • Phone: 919-851-1527
  • Fax:
Mailing address:
  • Phone: 919-851-1527
  • Fax: 919-851-3555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberA19677
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: