MEDICARE: JENNIFER MARIE SIMPSON MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	S0600380	OH

General Provider Information

NPI Number	:	1184781098
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER MARIE SIMPSON MSW

Provider Business Mailing Address
First Line	:	231 ALBERT SABIN WAY
Second Line	:	MAIL LOCATION 0559
City	:	CINCINNATI
State	:	OH
Zip	:	45267-0001
Country	:	US
Telephone Number	:	513-475-8110
Fax Number	:	513-475-8116

Provider Business Practice Location Address
First Line	:	222 PIEDMONT AVE
Second Line	:	#8200
City	:	CINCINNATI
State	:	OH
Zip	:	45219-4231
Country	:	US
Telephone Number	:	513-475-8110
Fax Number	:	513-475-8116

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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