MEDICARE: EMILY SIMPSON LMHC

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	21967	NC
2	101YP2500X	Professional Counselor	A11742	NC
3	101YP2500X	Professional Counselor	LPC.0014477	CO
4	101YM0800X	Mental Health Counselor	39003590A	IN

General Provider Information

NPI Number	:	1275993735
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY SIMPSON LMHC

Provider Business Mailing Address
First Line	:	3129 25TH ST STE 326
Second Line	:
City	:	COLUMBUS
State	:	IN
Zip	:	47203-2436
Country	:	US
Telephone Number	:	317-683-0516
Fax Number	:

Provider Business Practice Location Address
First Line	:	2549 E VANDALIA ROAD
Second Line	:
City	:	FLAT ROCK
State	:	IN
Zip	:	47234
Country	:	US
Telephone Number	:	317-683-0516
Fax Number	:

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

Provider Enumeration Date	:	02/26/2016
Last Update Date	:	11/19/2020

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