=====================================================
General NPI Number Information
=====================================================
NPI Number | 1902475577
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JEANNI N SIMPSON LCSW-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/18/2021
-----------------------------------------------------
Last Update Date | 01/07/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9308 CHERRY HILL RD APT 312
-----------------------------------------------------
City | COLLEGE PARK
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20740-1235
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-753-0290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4500 FORBES BLVD STE 200
-----------------------------------------------------
City | LANHAM
-----------------------------------------------------
State | MD
-----------------------------------------------------
Zip | 20706-6316
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 240-753-0290
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 27356
-----------------------------------------------------
License Number State | MD
-----------------------------------------------------