Healthcare Provider Details

I. General information

NPI: 1871866046
Provider Name (Legal Business Name): JUSTINE SIMPSON ED.D, LPCC-S
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2012
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2652 KULL RD
LANCASTER OH
43130-7707
US

IV. Provider business mailing address

2652 KULL RD
LANCASTER OH
43130-7707
US

V. Phone/Fax

Practice location:
  • Phone: 614-815-2300
  • Fax:
Mailing address:
  • Phone: 614-815-2300
  • Fax: 614-815-2300

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberE.1901488-SUPV
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: