Healthcare Provider Details

I. General information

NPI: 1023543055
Provider Name (Legal Business Name): AUSTIN SIMPSON PSYD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/27/2017
Last Update Date: 10/09/2024
Certification Date: 10/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 KIRMAN AVE STE 200
RENO NV
89502-1340
US

IV. Provider business mailing address

1155 MILL ST # MCM14
RENO NV
89502-1576
US

V. Phone/Fax

Practice location:
  • Phone: 775-982-2862
  • Fax: 775-982-2865
Mailing address:
  • Phone: 775-982-5262
  • Fax: 775-982-2865

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code103G00000X
TaxonomyClinical Neuropsychologist
License NumberPY1197
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: