Healthcare Provider Details

I. General information

NPI: 1457804155
Provider Name (Legal Business Name): PATRICIA A. SIMPSON, LCSW, BCD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2016
Last Update Date: 07/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

60 MAIN STREET
HICKORY PA
15340-0447
US

IV. Provider business mailing address

PO BOX 447
HICKORY PA
15340-0447
US

V. Phone/Fax

Practice location:
  • Phone: 724-356-4449
  • Fax: 724-356-4432
Mailing address:
  • Phone: 724-356-4449
  • Fax: 724-356-4432

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW005217L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier12516242
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMULTIPLAN
# 2
Identifier250857000
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMAGELLAN
# 3
Identifier117688
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerVBH-PA
# 4
Identifier70452561
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerOPTUM UNITED BEHAVIORAL HEALTH
# 5
IdentifierSI831951
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerHIGHMARK BLUE CROSS BLUE SHIELD
# 6
Identifier104398
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerUPMC
# 7
Identifier324423
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerMHN
# 8
Identifier11410204
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerCAQH
# 9
Identifier0018612100001
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer
# 10
Identifier7563290
Identifier TypeOTHER
Identifier StatePA
Identifier IssuerAETNA

VIII. Authorized Official

Name: PATRICIA ANN SIMPSON
Title or Position: SOLE OWNER
Credential: LCSW, BCD
Phone: 724-356-4449