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General NPI Number Information
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NPI Number | 1003056938
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Entity Type | Individual
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Provider Name | CHARLIE SIMPSON III LAMFT, LAC
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Gender | Male
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Dates
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Enumeration Date | 03/05/2009
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 4 SHACKLEFORD PLZ STE 100
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City | LITTLE ROCK
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State | AR
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Zip | 72211-1843
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Country | US
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Telephone | 501-313-1185
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 251703
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City | LITTLE ROCK
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State | AR
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Zip | 72225-1703
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Country | US
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Telephone | 501-952-7518
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A1012137
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | A1109014
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License Number State | AR
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