Healthcare Provider Details

I. General information

NPI: 1598926610
Provider Name (Legal Business Name): MOLLY SIMPSON LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/20/2008
Last Update Date: 12/04/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13207 WRIGHT RD
BUDA TX
78610-5000
US

IV. Provider business mailing address

8402 CROSS PARK DR
AUSTIN TX
78754-4595
US

V. Phone/Fax

Practice location:
  • Phone: 512-697-8511
  • Fax: 512-243-0472
Mailing address:
  • Phone: 512-697-8511
  • Fax: 512-243-0472

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number51919
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: