MEDICARE: MONIQUE SIMPSON

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	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1255656690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONIQUE SIMPSON

Provider Business Mailing Address
First Line	:	1727 AMSTERDAM AVE
Second Line	:	UPPER MANHATTAN MENTAL HEALTH CENTER
City	:	NY
State	:	NY
Zip	:	10031
Country	:	US
Telephone Number	:	212-694-9200
Fax Number	:	212-694-9230

Provider Business Practice Location Address
First Line	:	1727 AMSTERDAM AVE
Second Line	:	UPPER MANHATTAN MENTAL HEALTH CENTER
City	:	NY
State	:	NY
Zip	:	10031
Country	:	US
Telephone Number	:	212-694-9200
Fax Number	:	212-694-9230

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

Provider Enumeration Date	:	03/29/2010
Last Update Date	:	03/29/2010

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Directions to “ MONIQUE SIMPSON ” Practice Location

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