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General NPI Number Information
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NPI Number | 1386798411
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Entity Type | Individual
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Provider Name | SHELLY RENEA SIMPSON LSCSW
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Gender | Female
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 01/03/2014
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Provider Practice Location Address
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Address Line | 6155 OAK ST SUITE E
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City | KANSAS CITY
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State | MO
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Zip | 64113-2240
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Country | US
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Telephone | 816-333-0606
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Fax |
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Provider Business Mailing Address
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Address Line | 5732 N BEAMAN AVE
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City | KANSAS CITY
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State | MO
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Zip | 64151-3284
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Country | US
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Telephone | 816-830-4290
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 6652
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 4086
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 2013041160
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License Number State | MO
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